Digital dentistry

ABSTRACT

The systems and methods disclosed herein employ a scanning system for capturing highly detailed digital dental models. These models may be used within a dentist&#39;s office for a wide array of dental functions including quality control, restoration design, and fitting. These models may also, or instead, be transmitted to dental laboratories that may, alone or in collaboration with the originating dentist or other dental professionals, transform the digital model into a physical realization of a dental hardware item.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a national stage filing under 35 U.S.C. 371 ofPCT/US2007/001547, filed Jan. 19, 2007, which claims benefit of U.S.Provisional Application No. 60/761,078, filed Jan. 20, 2006, thedisclosure of which is incorporated by reference in its entirety herein.

BACKGROUND

1. Field of the Invention

The invention relates to dentistry, and more particularly for dentalapplications of digital, three-dimensional representations of dentition.

2. Description of the Related Art

Dentistry today largely continues in the mold of the past, usingtechniques pioneered by ancient Egyptians. One basic technique formanufacturing a dental restoration, the so-called lost wax method,employs a wax pattern from which a metal casting is made. A mold of thewax pattern is made using a high-heat investment material. The mold isthen heated in a furnace, the pattern is then burned out, and theinvestment ring is cast or filled with some type of alloy or some othersubstance to provide a final version of a dental restoration. A dentistbonds this prosthetic to a site in a patient's mouth that has beenhand-prepared to match the prosthetic. As a significant disadvantage, asubstantial burden is placed on practicing dentists to physically matchrestorations and tooth surfaces. Further complicating this process, thewax model itself is typically created from a physical cast of thepatient's mouth. The casting process can introduce errors into a finalrestoration, as can material handling in the multiple steps carried outby a dental laboratory to go from the original dental impression to thefinal restoration.

In theory, digital dentistry offers manifest advantages of quality,portability, and durability as compared to cast models of physicalimpressions. However, advances in dentistry have been muted, at least inpart due to the inability to easily capture adequate three-dimensionaldata for teeth and surrounding soft tissue. In addition, dentistry hasachieved only limited gains from general improvements in manufacturingtechnologies because each dental patient and restoration presents aunique, one-off product.

There remains a need for dentistry tools that capture high-qualitydigital dental models, as well as tools that permit the design andmanufacture of dental hardware from such models.

SUMMARY

The systems and methods disclosed herein employ a scanning system forcapturing highly detailed digital dental models. These models may beused within a dentist's office for a wide array of dental functionsincluding quality control, restoration design, and fitting. These modelsmay also, or instead, be transmitted to dental laboratories that may,alone or in collaboration with the originating dentist or other dentalprofessionals, transform the digital model into a physical realizationof a dental hardware item.

A method disclosed herein includes acquiring a three-dimensionalrepresentation of one or more intraoral structures of a dental patientusing an intraoral scanner; and providing the three-dimensionalrepresentation to a dental fabrication facility.

The method may further include fabricating a dental restoration at thedental fabrication facility using the three-dimensional representation.The dental fabrication facility may include a dental laboratory. The oneor more intraoral structures may include at least one dental implant, atleast one tooth, at least one tooth surface prepared for a dentalrestoration, at least one previously restored tooth, and/or at least onearea of soft tissue. The method may further include fabricating a dentalprosthesis at the dental fabrication facility using thethree-dimensional representation.

The method may further include transmitting the three-dimensionalrepresentation to a dental laboratory and, in response, receiving anassessment of quality for the three-dimensional representation from thedental laboratory. The assessment of quality may be received before thedental patient leaves a dentist's office. The assessment of quality mayinclude an assessment of acceptability of the three-dimensionalrepresentation. The method may further include transmitting thethree-dimensional representation to a dental laboratory and, inresponse, receiving an assessment of quality of the at least oneprepared tooth surface. Transmitting the three-dimensionalrepresentation to a dental fabrication facility may include transmittingto a remote dental laboratory for fabrication of a dental restorationfor the one or more intraoral structures. The method may further includetransmitting the three-dimensional representation to a dental data hub.The method may further include transmitting a prescription for thedental restoration with the three-dimensional representation. The methodmay further include transmitting the three-dimensional representation toa model production laboratory. The model production laboratory may be amilling facility, a manufacturing facility, or a three-dimensional rapidprototyping facility. Transmitting the three-dimensional representationto a dental fabrication facility may include providing thethree-dimensional representation to an in-office dental laboratory forfabrication of a dental restoration for the one or more intraoralstructures.

A computer program product disclosed herein includes computer executablecode embodied in a computer readable medium that, when executed on oneor more computer devices, may perform the steps of: acquiring one ormore images of one or more intraoral structures of a dental patient froman intraoral scanner; converting the one or more images into athree-dimensional representation of the one or more intraoralstructures; and transmitting the three-dimensional representation to adental fabrication facility.

The computer program may further include computer code that performs thestep of comparing quality of the three-dimensional representation topredefined quality criteria. The predefined quality criteria may includeacceptability of the three-dimensional representation for fabrication.The computer program may further include computer code that performs thesteps of: retrieving a prescription for at least one of a prosthesis oran appliance by a dentist; and combining the prescription with thethree-dimensional representation prior to transmitting thethree-dimensional representation. The one or more intraoral structuresmay include at least one dental implant, one tooth, or one tooth surfaceprepared for a dental restoration. The computer program may furtherinclude computer code that performs the step of comparing quality of theat least one prepared tooth surface to predefined quality criteria. Theone or more intraoral structures may include at least one area of softtissue.

A system disclosed herein includes an intraoral scanner for acquiring athree-dimensional representation of one or more intraoral structures ofa dental patient; and a transmission means for transmitting thethree-dimensional representation to a dental fabrication facility.

The system may further include a first fabrication means for fabricatinga dental restoration at the dental fabrication facility using thethree-dimensional representation. The one or more intraoral structuresmay include at least one dental implant, one tooth, least one toothsurface prepared for a dental restoration, or one area of soft tissue.The system may further include a second fabrication means forfabricating a dental prosthesis at the dental fabrication facility usingthe three-dimensional representation. The system may further include aquality assessment means for assessing quality of the three-dimensionalrepresentation. The quality assessment means may include a means fordetermining acceptability of the three-dimensional representation foruse with the first fabrication means. The quality assessment means mayinclude a means for determining acceptability of the three-dimensionalrepresentation for use with the second fabrication means. The one ormore intraoral structures may include at least one tooth surfaceprepared for a dental restoration, wherein the quality assessment meansincludes a means for determining quality of the at least one preparedtooth surface.

In another aspect, a method disclosed herein includes receiving athree-dimensional representation of a tooth, the tooth prepared for adental restoration; specifying a cementation void between the toothsurface and the dental restoration; and fabricating the dentalrestoration such that the dental restoration, when mated to the toothsurface, defines an empty space corresponding to the cementation void.

The method may include adjusting the cementation void, such as accordingto a dentist's preferences or according to the type of cement to be usedin the cementation void. The cementation void may be specified by adentist. The dentist may send the specification to a dental laboratory.The cementation void may be specified by a dental laboratory. The methodmay include three-dimensionally printing a die including the cementationvoid. The method may include fabricating a die including the cementationvoid with a stereo lithography apparatus. The method may includethree-dimensionally printing a wax-up including the cementation void.The method may include milling a die including the cementation void. Themethod may include integrating the cementation void into a digitalsurface representation of the tooth. The method may include integratingthe cementation void into a dental model. The three-dimensionalrepresentation may include a digital surface representation of thetooth. Fabricating the dental restoration may include fabricating thedental restoration in an in-house laboratory in a dentist's office. Themethod may further include fabricating an opposing arch for an archincluding the tooth, the opposing arch including a die spacer having apredetermined thickness.

In another aspect, a computer program product disclosed herein includescomputer executable code embodied in a computer readable medium that,when executed on one or more computer devices, performs the steps of:acquiring one or more images of a tooth of a dental patient from anintraoral scanner, the tooth including a tooth surface prepared for adental restoration; converting the one or more images into athree-dimensional representation of the tooth; specifying a cementationvoid between the tooth surface and the dental restoration; combining thespecification for the cementation void with the three-dimensionalrepresentation into a fabrication specification; and transmitting thefabrication specification to a dental fabrication facility.

A dentist may specify the cementation void. The computer program productmay include code that performs the step of receiving a specification ofthe cementation void from the dental fabrication facility. The computerprogram product may include code for three-dimensionally printing thecementation void to a die. The computer program product may include codefor three-dimensionally printing the cementation void to a wax up. Thecomputer program product may include code that performs the step ofintegrating the cementation void into a digital surface representationof the tooth.

In another aspect, a system disclosed herein includes a first means forthree-dimensionally representing a tooth, the tooth prepared for adental restoration; a second means for specifying a cementation void,the cementation void representing an empty space between the toothsurface and the dental restoration; and a fabrication means forfabricating the dental restoration such that the dental restoration,when mated to the tooth surface, defines an empty space corresponding tothe cementation void.

The system may include an adjustment means for adjusting the cementationvoid. The adjustment means may include means for incorporating adentist's preferences. The adjustment means may include means foradjusting the cementation void according to a type of cement. The systemmay include a first printing means for three-dimensionally printing adie including the cementation void. The system may include a secondprinting means for three-dimensionally printing a wax-up including thecementation void. The system may include a milling means for milling adie including the cementation void. The system may include a millingmeans for milling an investment chamber for casting including thecementation void. The system may include a model means for integratingthe cementation void into a model of a dental impression. Thethree-dimensional representation of a tooth may include a digitalsurface representation of the tooth.

In another aspect, a method disclosed herein includes fabricating adental object; acquiring a first three-dimensional representation of theobject; and measuring a dimensional accuracy of the firstthree-dimensional representation. The first three-dimensionalrepresentation may include a digital surface representation. The dentalobject may include a dental prosthesis, a dental implant, a dentalappliance, a dental restoration, a restorative component, or anabutment. The method may include acquiring a second three-dimensionalrepresentation of one or more teeth including at least one tooth surfaceprepared for the dental object, wherein measuring a dimensional accuracymay include evaluating a fit between the item of the firstthree-dimensional representation and the at least one tooth surface ofthe second three-dimensional representation. The method may furtherinclude acquiring a second three-dimensional representation of one ormore teeth including at least one tooth surface prepared for the dentalobject, wherein measuring a dimensional accuracy may include evaluatingone or more contact points between the item of the firstthree-dimensional representation and the one or more teeth of the secondthree-dimensional representation when the item is virtually affixed tothe at least one tooth surface. The method may further include acquiringa second three-dimensional representation of one or more teeth includingat least one tooth surface prepared for the dental object and at leastone opposing tooth, wherein measuring a dimensional accuracy may includeevaluating one or more contact points between the item of the firstthree-dimensional representation and the at least one opposing tooth ofthe second three-dimensional representation when the item is virtuallyaffixed to the at least one tooth surface. The second three-dimensionalrepresentation may be acquired as a plurality of separate scans. Thesecond three-dimensional representation may be acquired as a continuousscan of the at least one tooth surface and the at least one opposingtooth in occlusion. A dentist may specify tightness of fit of the dentalobject. Measuring a dimensional accuracy may include quantifyingtightness of fit of the dental object. Measuring a dimensional accuracyincludes measuring quality of a margin.

A computer program product may include computer executable code embodiedin a computer readable medium that, when executed on one or morecomputer devices, performs the steps of: acquiring one or more images ofa dental object, converting the one or more images of the dental objectinto a first three-dimensional representation of the item; and measuringa dimensional accuracy of the first three-dimensional representation.The first three-dimensional representation may include a digital surfacerepresentation.

The dental object may include a dental prosthesis, a dental implant, adental appliance, a dental restoration, a restorative component, or anabutment. The computer program product may include code that performsthe steps of: acquiring one or more images of one or more teethincluding at least one tooth surface prepared for the dental object; andconverting the one or more images of the one or more teeth into a secondthree-dimensional representation of the one or more teeth, whereinmeasuring a dimensional accuracy includes evaluating a fit between theitem of the first three-dimensional representation and the at least onetooth surface of the second three-dimensional representation. Thecomputer program product may include code that performs the steps of:acquiring one or more images of one or more teeth including at least onetooth surface prepared for the dental object; converting the one or moreimages of the one or more teeth into a second three-dimensionalrepresentation of the one or more teeth; and generating one or morecontact points between the item of the first three-dimensionalrepresentation and the one or more teeth of the second three-dimensionalrepresentation by virtually affixing the item to the at least one toothsurface, wherein measuring includes evaluating one or more contactpoints.

The computer program product may further include computer code thatperforms the steps of: acquiring one or more images of one or more teethincluding at least one tooth surface prepared for the dental object andat least one opposing tooth; converting the one or more images of theone or more teeth and the at least one opposing tooth into a secondthree-dimensional representation of the one or more teeth and the atleast one opposing tooth; and generating one or more contact pointsbetween the item of the first three-dimensional representation and theat least one opposing tooth of the second three-dimensionalrepresentation by virtually affixing the item to the at least one toothsurface, wherein measuring includes evaluating one or more contactpoints. Measuring a dimensional accuracy may include quantifyingtightness of fit of the dental object. Measuring a dimensional accuracymay include measuring quality of a margin.

A system disclosed herein includes a fabrication means for fabricating adental object; a first means for acquiring a first three-dimensionalrepresentation of the item; and a measurement means for measuring adimensional accuracy of the first three-dimensional representation. Thefirst three-dimensional representation may include a digital surfacerepresentation.

The dental object may include a dental prosthesis, a dental implant, adental appliance, a dental restoration, a restorative component, or anabutment. The system may further include a second means for acquiring asecond three-dimensional representation of one or more teeth includingat least one tooth surface prepared for the dental object, whereinmeasuring a dimensional accuracy may include evaluating a fit betweenthe item of the first three-dimensional representation and the at leastone tooth surface of the second three-dimensional representation. Thesystem may further include a second means for acquiring a secondthree-dimensional representation of one or more teeth including at leastone tooth surface prepared for the dental object, wherein measuring adimensional accuracy may include evaluating one or more contact pointsbetween the item of the first three-dimensional representation and theone or more teeth of the second three-dimensional representation whenthe item is virtually affixed to the at least one tooth surface. Thesystem may further include a second means for acquiring a secondthree-dimensional representation of one or more teeth including at leastone tooth surface prepared for the dental object and at least oneopposing tooth, wherein measuring a dimensional accuracy may includeevaluating one or more contact points between the item of the firstthree-dimensional representation and the at least one opposing tooth ofthe second three-dimensional representation when the item is virtuallyaffixed to the at least one tooth surface. A dentist may specifytightness of fit of the dental object. Measuring a dimensional accuracymay include quantifying tightness of fit of the dental object. Measuringa dimensional accuracy includes measuring quality of a margin.

A method disclosed herein includes acquiring a three-dimensionalrepresentation including three-dimensional surface data for at least twoindependent dental structures; and acquiring motion data characterizinga relative motion of the at least two independent dental structures withrespect to one another within a mouth.

The method may include deriving TMJ condyle paths of rotation andtranslation from the motion data and the three-dimensional surface data.The method may include providing input to a virtual dental articulator.The method may include providing specifications for a physical dentalarticulator. The method may include providing specifications for adisposable dental articulator. Acquiring the three-dimensionalrepresentation may include acquiring the three-dimensionalrepresentation using an intraoral scanner. Acquiring motion data mayinclude acquiring motion data from a video source.

A computer program product disclosed herein includes computer executablecode embodied in a computer readable medium that, when executed on oneor more computer devices, may perform the steps of: acquiring one ormore images of at least two independent dental structures of a dentalpatient from an intraoral scanner; converting the one or more imagesinto a three-dimensional representation of the at least two independentdental structures; acquiring motion data characterizing a relativemotion of the at least two independent dental structures with respect toone another; and combining the three-dimensional representation with themotion data to derive TMJ condyle paths of rotation and translation.

The computer program may include code that performs the steps of:generating an image sequence of the combined three-dimensionalrepresentation and the motion data; generating a display signal of theimage sequence. Acquiring motion data may include acquiring motion datafrom a video source.

A system disclosed herein includes a first means for acquiring one ormore images of at least two independent dental structures of a dentalpatient; a conversion means for converting the one or more images into athree-dimensional representation of the at least two independent dentalstructures; and a second means for acquiring motion data characterizinga relative motion of the at least two independent dental structures withrespect to one another. The system may include an analysis means forderiving TMJ condyle paths of rotation and translation using thethree-dimensional representation and the motion data.

The system may include an action means for combining thethree-dimensional representation and the motion data to generate anarticulation input. The system may include a first model means forvirtually articulating the articulation input. The system may include asecond model means for physically articulating the articulation input.The system may include a disposable model means for physicallyarticulating the articulation input. The first means may include a meansfor acquiring the one or more images using an intraoral scanner. Thesecond means may include a means for acquiring the motion data from avideo source.

In another aspect, a method disclosed herein includes receiving anelectronic dental prescription including prescription data, a firstthree-dimensional representation of one or more intraoral structuresincluding at least one tooth surface prepared for an artificial dentalobject, and a second three-dimensional representation of the at leastone tooth surface prior to preparation for the artificial dental object;and fabricating the artificial dental object for the one or moreintraoral structures using the electronic dental prescription.

Receiving an electronic dental prescription may include receiving athree-dimensional representation from a dental data hub or from adentist. Receiving a three-dimensional representation may includereceiving a prescription for a dental restoration for the tooth surface.At least one of the first and second three-dimensional representationsmay include a digital surface representation of a full arch. Theelectronic dental prescription may include a prescription for anappliance, a prosthesis, or an item of dental hardware. Fabricating anartificial dental object may include fabricating a dental restoration inan in-house laboratory in a dentist's office.

A system disclosed herein includes a communication means for receiving aprescription data, a first three-dimensional representation of one ormore intraoral structures including at least one tooth surface preparedfor an artificial dental object, and a second three-dimensionalrepresentation of the at least one tooth surface prior to preparationfor the artificial dental object; and a fabrication means forfabricating a dental restoration for the one or more intraoralstructures using the three-dimensional representation.

The communication means may include a means for receiving the electronicdental prescription from a dental data hub or a dentist. The electronicdental prescription may include a prescription for a dental restoration.At least one of the first and second three-dimensional representationsmay include a digital surface representation of a full arch. Theelectronic dental prescription may include a prescription for one ormore of an appliance, a prosthesis, and an item of dental hardware. Thefabrication means may include in an in-house laboratory in a dentist'soffice.

In another aspect, a method disclosed herein includes a single dentalvisit, the steps of: acquiring a three-dimensional representation of oneor more intraoral structures from a dental patient, the intraoralstructures may include at least one tooth surface prepared for anartificial dental object; and processing the three-dimensionalrepresentation to provide feedback to a dentist concerning the at leastone tooth surface.

The feedback may identify corrective action. The corrective action mayinclude acquiring an additional three-dimensional representation of theone or more intraoral structures. The corrective action may includeadditional surface preparation of the at least one tooth. The feedbackmay identify a margin for fitting the dental restoration to the at leastone tooth surface. The margin for fitting may be edited. The feedbackmay include a visual display of one or more regions of inadequate marginfor fitting the dental restoration to the at least one tooth surface.The feedback may include a visual display recommending additionalpreparatory work required for the at least one tooth surface. Thefeedback may include a visual display recommending acquiring additionalthree-dimensional representations of one or more regions of the one ormore intraoral structures. The feedback may include identifying anincomplete three-dimensional representation. The feedback may includeidentifying errors in the three-dimensional representation. The feedbackmay include visual highlighting of a margin line on a display of thethree-dimensional representation.

A computer program product disclosed herein includes computer executablecode embodied in a computer readable medium that, when executed on oneor more computer devices, performs the steps of: acquiring one or moreimages of one or more intraoral structures of a dental patient, theintraoral structures including at least one tooth surface prepared foran artificial dental object; converting the one or more images into athree-dimensional representation of the one or more intraoralstructures; analyzing the at least one tooth surface within thethree-dimensional representation; generating a feedback signal, thefeedback signal representative of the result of analyzing the at leastone tooth surface; and outputting the feedback signal to providefeedback to a dentist.

The feedback signal may identify corrective action. The correctiveaction may include acquiring an additional one or more images of the oneor more intraoral dental structures. The corrective action may includeadditional surface preparation of the at least one tooth. The feedbacksignal may identify a margin for fitting the dental restoration to theat least one tooth surface. The margin for fitting may be edited.

In another aspect, a system disclosed herein includes a scanning deviceconfigured to intraorally capture surface image data from a surfacewithin a mouth of a dental patient; a computer coupled to the scanningdevice and receiving the surface image data therefrom, the computerconfigured to resolve the surface image data into a digital surfacereconstruction, the computer further configured to generate avisualization of the digital surface reconstruction and provide thevisualization as a display signal; and a display coupled to the computerand receiving the display signal therefrom, the display converting thedisplay signal into a viewable image of the visualization. The surfacemay include dentition.

The scanning device may capture surface image data at a video framerate. The system may include a user interface controlled by the computerand rendered on the display. The user interface may provide at least onetool for analyzing the surface. The user interface may include a toolthat may provide real time feedback to the user. The real time feedbackmay include visual cues within the rendered image. The at least one toolmay include a distance measurement tool, a tool that may evaluateadequacy of tooth structure removal from a dental restoration surfacepreparation, a tool that may evaluate adequacy of margin preparations, atool that evaluates taper, a tool that evaluates undercut, or a toolthat identifies scan deficiencies. The scan deficiencies may includeholes in the surface. The at least one tool may include a tool thatevaluates adequacy of removal path in multiple unit preparation. The atleast one tool may include a tool that identifies irregularities in oneor more occlusal surfaces requiring further preparation. Analyzing thesurface may include an evaluation of suitability for three-dimensionalprinting, of suitability for milling, or of suitability for manualfabrication.

The computer may be further configured to automatically annotate thevisualization with a visual indication of an evaluation. The visualindication includes an evaluation of contour of a surface preparation.The surface image data may include at least two tooth surfaces inocclusion. The visual indication may include an evaluation of margin ofa surface preparation. The visual indication includes an evaluation ofocclusal clearance of a surface preparation. The surface may include atleast one surface prepared for a dental restoration, the evaluationincluding an evaluation of an adequacy of the at least one surface forreceiving the dental restoration. The visual indication may includedisplay of a contour of an actual tooth and a computer-generated surfacepreparation. The computer-generated surface preparation may be basedupon intact configuration of the actual tooth prior to preparation.

In another aspect, a method disclosed herein includes receiving athree-dimensional representation that may include three-dimensionalsurface data from an intraoral structure including at least one toothhaving a tooth surface prepared for a dental restoration; and presentingthe three-dimensional representation in a user interface, the userinterface may include a first tool for identifying a margin line for thedental restoration on the at least one tooth and a second tool forrecessing a region of the three-dimensional representation below themargin line.

The first tool may provide automated identification of the margin line.The method may include removing a portion of the three-dimensionalrepresentation below the margin line with the second tool. The methodmay include removing a portion of the three-dimensional representationbelow the margin line with the second tool to provide a virtual ditcheddie, and three-dimensionally printing the ditched die.

A system disclosed herein includes a means for receiving athree-dimensional representation including three-dimensional surfacedata from an intraoral structure that may include at least one toothhaving a tooth surface prepared for a dental restoration; and a userinterface means for presenting the three-dimensional representation to auser, the user interface means may include a first tool means foridentifying a margin line for the dental restoration on the at least onetooth and a second tool means for recessing a region of thethree-dimensional representation below the margin line.

The first tool means may include a means for providing automatedidentification of the margin line. The system may include a means forremoving a portion of the three-dimensional representation below themargin line. The system may include a means for removing a portion ofthe three-dimensional representation below the margin line to provide avirtual ditched die, and a means for three-dimensionally printing theditched die.

In another aspect, a method disclosed herein includes acquiring adigital dental impression that may include three-dimensional surfacedata for at least two independent dental structures; and acquiringorientation data that may define a relative position of at least aportion of each of the at least two independent dental structures whilein occlusion.

The orientation data may include three-dimensional surface data thatspans the at least two independent dental structures while in occlusion.The orientation data may include three-dimensional surface data fromeach of the at least two independent dental structures while inocclusion. The occlusion may include a centric occlusion. The method mayinclude applying the orientation data to position a virtual model of theat least two independent dental structures in a virtual articulator. Themethod may include fabricating models of each of the at least twoindependent dental structures and may apply the orientation data toposition the models within a dental articulator. Acquiring orientationdata may include acquiring three-dimensional data of a buccal side ofdentition. Acquiring orientation data may include acquiringthree-dimensional data of a labial side of dentition.

A system disclosed herein includes a first acquisition means foracquiring a digital dental impression including three-dimensionalsurface data for at least two independent dental structures; and asecond acquisition means for that may acquire orientation data defininga relative position of at least a portion of each of the at least twoindependent dental structures while in occlusion.

The orientation data may include three-dimensional surface data thatspans the at least two independent dental structures while in occlusion.The orientation data may include three-dimensional surface data fromeach of the at least two independent dental structures while inocclusion. The occlusion may include a centric occlusion. The system mayinclude a model means for virtually articulating the at least twoindependent dental structures. The system may include a fabricationmeans for fabricating models of each of the at least two independentdental structures; and a model means for physically articulating thefabricated models. The orientation data may include three-dimensionaldata of a buccal side of dentition. The orientation data may includethree-dimensional data of a labial side of dentition.

In another aspect, a method disclosed herein includes providing anintraoral three-dimensional scanning device; and scanning a plurality ofteeth in an arch with the device in a scan path that may include amotion that begins at a first lingual point, traverses laterally over afirst occlusal point and a first buccal point, translates to a secondbuccal point adjacent to the first buccal point, and then traverseslaterally over a second occlusal point adjacent to the first occlusalpoint and a second lingual point adjacent to the first lingual point.

The method may include scanning the plurality of teeth in the arch withthe device using a motion that translates to a third lingual point, andthen may traverse laterally over a third occlusal point adjacent to thesecond occlusal point and a third buccal point adjacent to the secondbuccal point. The first lingual point and the second lingual point maybe spaced apart such that a field of view of the scanning deviceincludes at least one overlapping portion of the plurality of teeth whenthe scanning device is positioned to image the first and second lingualpoints respectively. The scan path may begin at a third buccal point, athird palatal point, or a third labial point.

In another aspect, a method disclosed herein includes within a singledental visit, the steps of: acquiring a three-dimensional representationof one or more intraoral structures including at least one toothprepared for a dental restoration; and processing the three-dimensionalrepresentation that may provide feedback to a dentist concerning the atleast one tooth.

The feedback may include a physical dimension, a dimension of the atleast one tooth prior to preparation for the dental restoration, acontour of the at least one tooth, a clearance relative to one or moreadjacent teeth for a dental restoration associated with the at least onetooth, or a position of the at least one tooth. The feedback may includea clearance relative to one or more teeth in an opposing occluded arch.

A computer program product disclosed herein includes computer executablecode embodied in a computer readable medium that, when executed on oneor more computer devices, performs the steps of: acquiring athree-dimensional representation of one or more intraoral structuresthat may include at least one tooth prepared for a dental restoration;analyzing the three-dimensional representation; generating a feedbacksignal, the feedback signal may represent the analysis of thethree-dimensional representation; and outputting the feedback signal toa dentist.

The feedback signal may include a physical dimension, a dimension of theat least one tooth prior to preparation for the dental restoration, acontour of the at least one tooth, a clearance relative to one or moreadjacent teeth for a dental restoration associated with the at least onetooth, or a position of the at least one tooth. The feedback may includea clearance relative to one or more teeth in an opposing occluded arch.

A system disclosed herein includes an acquisition means for acquiring athree-dimensional representation of one or more intraoral structuresincluding at least one tooth prepared for a dental restoration; ananalysis means for analyzing the three-dimensional representation; ameans for generating a feedback signal, the feedback signal representingthe analysis of the three-dimensional representation; and a signal meansfor providing the feedback signal to a dentist.

The feedback signal may include a physical dimension, a dimension of theat least one tooth prior to preparation for the dental restoration, acontour of the at least one tooth, a clearance relative to one or moreadjacent teeth for a dental restoration associated with the at least onetooth, or a position of the at least one tooth. The feedback may includea clearance relative to one or more teeth in an opposing occluded arch.

In another aspect, a method disclosed herein includes acquiring athree-dimensional representation from a dental patient including adigital surface representation of one or more intraoral structures; andproviding a visual display of the three-dimensional representation inreal time. The visual display of the three-dimensional representationmay be superimposed on a real time two-dimensional video image of theone or more intraoral structures.

The one or more intraoral structures may include at least one tooth, atleast one tooth surface prepared for a dental restoration, at least onerestored tooth, at least one implant, or at least one area of softtissue. The method may include processing the three-dimensionalrepresentation to generate user feedback concerning the one or moreintraoral structures, and may provide a visual display of the userfeedback. The feedback may include highlighting areas in thethree-dimensional representation requiring additional attention.

A computer program product disclosed herein includes computer executablecode embodied in a computer readable medium that, when executed on oneor more computer devices, performs the steps of: acquiring one or moreimages of one or more intraoral structures; processing the one or moreimages into a three-dimensional representation including a digitalsurface representation of the one or more intraoral structures; andgenerating a first visual display signal of the three-dimensionalrepresentation in real time.

The computer program product may include computer code that performs thestep of generating a second visual display signal wherein thethree-dimensional representation is superimposed on a real timetwo-dimensional video image of the one or more intraoral structures. Theone or more intraoral structures may include at least one tooth, atleast one tooth surface prepared for a dental restoration, at least onerestored tooth, at least one implant, or at least one area of softtissue. The computer program product may include computer code thatperforms the steps of: analyzing the three-dimensional representation;may generate a feedback signal representative of the analysis of thethree-dimensional representation; generate a third visual display signalincluding the feedback signal. The third visual display signal mayinclude highlighted areas of the three-dimensional representationrequiring additional attention.

A system disclosed herein includes: an acquisition means for acquiring athree-dimensional representation from a dental patient, thethree-dimensional representation may include a digital surfacerepresentation of one or more intraoral structures; and a display meansfor visually displaying the three-dimensional representation in realtime.

The display means may include a means for superimposing thethree-dimensional representation on a real time two-dimensional videoimage of the one or more intraoral structures. The one or more intraoralstructures may include at least one tooth, at least one tooth surfaceprepared for a dental restoration, at least one restored tooth, at leastone implant, or at least one area of soft tissue. The system mayinclude: an analysis means for analyzing the three-dimensionalrepresentation; a feedback means for generating a feedback signalrepresentative of the analysis of the three-dimensional representation,wherein the display means includes a means for visually displaying thefeedback signal. The feedback means may include a means for highlightingareas in the three-dimensional representation requiring additionalattention.

In another aspect, a handheld imaging device for a three-dimensionalimaging system disclosed herein includes: an elongated body including afirst end, a second end, and a central axis; a video ratethree-dimensional scanning device within the elongated body, the videorate three-dimensional scanning device may have an optical axis forreceiving images, the optical axis substantially perpendicular to thecentral axis at a position near the first end of the elongated body; andthe second end adapted for gripping by a human hand, and the second endmay include a user input responsive to user manipulation to generatecontrol signals for transmission to a processor associated with theimaging system. The user input may include a mouse, track ball, button,switch, mini joystick, touchpad, keypad, or thumb wheel. The controlsignals may be transmitted to the processor through a wirelesscommunication medium. The user input may control a user interfaceassociated with the imaging system.

A handheld imaging device for a three-dimensional imaging systemdisclosed herein includes: an elongated body including a central axis, afirst end, and a second end, the second end adapted for gripping by ahuman hand and a central axis; a video rate three-dimensional scanningdevice within the elongated body, the video rate three-dimensionalscanning device having an optical axis for receiving images, the opticalaxis substantially perpendicular to the central axis at a position nearthe first end of the elongated body; and a physical offset shaped andsized to maintain a desired distance of the first end from an imagingsubject along the optical axis. The physical offset may include one ormore wheels for slidably engaging a surface of the imaging subject.

In another aspect, a method disclosed herein includes: acquiring athree-dimensional representation from a dental patient including adigital surface representation of one or more intraoral structures, theintraoral structures may include a dental arch; processing thethree-dimensional representation that may provide a digital dental modelincluding one or more alignment guides to aid in positioning anorthodontic fixture; and fabricating a physical model from the digitaldental model.

The method may include constructing the orthodontic fixture on thephysical model using the alignment guides. The method may includeconstructing a support for the orthodontic fixture on the digital dentalmodel. The alignment guides may include visual markings. The alignmentguides may include at least one substantially horizontal shelf for theorthodontic fixture. Processing may include virtually placing aplurality of orthodontic brackets onto the three-dimensionalrepresentation, and adding a plurality of bracket supports to thedigital dental model to support a physical realization of the pluralityof orthodontic brackets on the physical model. The method may includefabricating the physical realization of the plurality of orthodonticbrackets, positioning each one of the plurality of orthodontic bracketsonto the physical model, and vacuum forming an appliance over theplurality of orthodontic brackets, the appliance maintaining theplurality of orthodontic brackets in fixed relation to one another. Themethod may include applying the appliance with the plurality oforthodontic brackets to the dental arch. The appliance may be formed ofa soft, clear material. The method may include transmitting the digitaldental model to a remote dental laboratory. Processing may includevirtually placing a plurality of orthodontic brackets onto thethree-dimensional representation in a bracket arrangement, andgenerating a digital model of a bracket guide adapted to position aphysical realization of the plurality of orthodontic brackets in thebracket arrangement on the dental arch. The method may includethree-dimensionally printing the bracket guide. The physical model mayinclude fabricating the physical model in an in-house dental laboratoryin a dentist's office.

In another aspect, a method disclosed herein includes: acquiring athree-dimensional representation from a dental patient including adigital surface representation of one or more intraoral structures, theintraoral structures may include a dental arch; adding a plurality ofvirtual brackets to the three-dimensional representation to provide abracket model; processing the bracket model to generate a bracket guidemodel, the bracket guide model adapted to maintain a physicalrealization of the plurality of virtual brackets in a fixed orientationwith respect to one another, the fixed orientation corresponding to adesired orientation of the physical realization on the dental arch;fabricating a bracket guide from the bracket guide model; and attachingthe physical realization of the plurality of virtual brackets to thebracket guide model.

A computer program product disclosed herein includes computer executablecode embodied in a computer readable medium that, when executed on oneor more computer devices, performs the steps of: acquiring one or moreimages of one or more intraoral structures, the intraoral structures mayinclude a dental arch; processing the one or more images into athree-dimensional representation of the one or more intraoralstructures; transforming the three-dimensional representation into adigital dental model, the digital dental model including one or moreorthodontic fixture alignment guides; and generating a virtualorthodontic fixture using the alignment guides.

The computer program product may include code that performs the step ofconstructing a support for the virtual orthodontic fixture on thedigital dental model. The alignment guides may include visual markings.The alignment guides may include at least one substantially horizontalshelf for the virtual orthodontic fixture. Transforming may includevirtually placing a plurality of orthodontic brackets onto the dentalarch of the three-dimensional representation, and adding a plurality ofbracket supports to the digital dental model. The computer programproduct may include code that performs the step of transmitting thedigital dental model to a remote dental laboratory.

A system disclosed herein includes: an acquisition means for acquiring athree-dimensional representation from a dental patient including adigital surface representation of one or more intraoral structures, theintraoral structures may include a dental arch; a processing means forprocessing the three-dimensional representation that may provide adigital dental model including one or more alignment guides to aid inpositioning an orthodontic fixture; and a first fabrication means forfabricating a physical model from the digital dental model.

The system may include a means for constructing the orthodontic fixtureon the physical model using the alignment guides. The processing meansmay include a means for constructing a support for the orthodonticfixture on the digital dental model. The alignment guides may includevisual markings. The alignment guides may include at least onesubstantially horizontal shelf for the orthodontic fixture. Theprocessing means may include a means for virtually placing a pluralityof orthodontic brackets onto the three-dimensional representation, andadding a plurality of bracket supports to the digital dental model tosupport a physical realization of the plurality of orthodontic bracketson the physical model. The system may include a second fabrication meansfor fabricating the physical realization of the plurality of orthodonticbrackets, a positioning means for positioning each one of the pluralityof orthodontic brackets onto the physical model, and a forming means forvacuum forming an appliance over the plurality of orthodontic brackets,the appliance maintaining the plurality of orthodontic brackets in fixedrelation to one another. The system may include a means for applying theappliance with the plurality of orthodontic brackets to the dental arch.The appliance may be formed of a soft, clear material. The system mayinclude a communication means for transmitting the digital dental modelto a remote dental laboratory. The processing means may include a meansfor virtually placing a plurality of orthodontic brackets onto thethree-dimensional representation in a bracket arrangement, and a modelmeans for generating a digital model of a bracket guide adapted toposition a physical realization of the plurality of orthodontic bracketsin the bracket arrangement on the dental arch. The system may include aprinting means for three-dimensionally printing the bracket guide. Thefabrication means may include a means for fabricating the physical modelin an in-house dental laboratory in a dentist's office.

A three-dimensional data acquisition system adapted for intraoralacquisition of dental data from one or more intraoral structures, asdisclosed herein, may include a first operating mode for capturing scandata and rendering a low-quality three-dimensional image from the scandata in real time, and a second operating mode for generating ahigh-quality three dimensional image from the scan data after exitingthe first operating mode, the high-quality three-dimensional image mayhave greater spatial resolution than the low-quality three-dimensionalimage.

The system may further including a display that renders the low-qualitythree-dimensional image superimposed on a video image of the one or moreintraoral structures. Rendering a low-quality three-dimensional imagemay include rendering the low-quality three-dimensional image at a framerate of the video image. The system may include a communicationsinterface for transmitting the high-quality three-dimensional image to adental laboratory.

In another aspect, a system disclosed herein includes: a scanning deviceconfigured to intraorally capture surface image data from a surfacewithin a mouth of a dental patient; a computer coupled to the scanningdevice and receiving the surface image data therefrom, the computerconfigured to resolve the surface image data into a three-dimensionalrepresentation, the computer may be further configured to generate avisualization of the three-dimensional representation and to provide thevisualization as a display signal; and a display coupled to the computerand receiving the display signal therefrom, the display adapted toconvert the display signal into a viewable image, the display being atouch-screen display adapted to receive a user input through directcontact with a surface of the display, wherein the user input isinterpreted by the computer to affect manipulation of thethree-dimensional representation. The user input may affect rotationalorientation of the visualization on the display.

The display may include areas for one or more user controls accessiblethrough the touch-screen display. The user controls may include a zoomcontrol, a pan control, or case management controls. The case managementcontrols may include a control to transmit the three-dimensionalrepresentation to a dental lab, a control to evaluate quality of thethree-dimensional representation, a tool to edit the three-dimensionalrepresentation, or a control to create a dental prescription.

The user controls may include a control to define a cementation void, acontrol to define a margin line, a control to infer a margin line fromthe three-dimensional representation, a control to recess a region ofthe three-dimensional representation below a margin line, a control tovirtually fit a dental restoration to a prepared tooth surface, includea virtual dental articulator, or include a tool to design a dentalrestoration fitted to the surface within the mouth of the dentalpatient.

The three-dimensional model may include two arches; the display mayinclude an area for one or more user controls accessible through thetouch-screen display to permit positioning the two arches within avirtual articulator. The system may include a user interface displayedon the display and controlled by the computer. The user interface may beaccessible through the touch-screen.

A system disclosed herein includes: a digital dental impression that mayinclude three-dimensional digital surface data for one or more intraoralstructures, the digital dental impression may be captured using athree-dimensional intraoral scanning device and stored in a computerreadable medium; a first computer may be configured to render thedigital dental impression from a point of view; and a second computer ata remote location may be configure to simultaneously render the digitaldental impression from the point of view.

The system may include a control for passing control of the point ofview between the first computer and the second computer. The system mayinclude the first computer and the second computer including acollaborative tool for manipulating the model, for sectioning the model,or for rearranging one or more sections of the model. The system mayinclude the first computer and the second computer including acollaborative cursor control tool. The system may include the firstcomputer and the second computer connected by a communication channel.The communication channel may include one or more of VoIP, IRC, videoconferencing, or instant messaging. The second computer may be operatedby a consulting dentist, a dental technician, in a dental laboratory, orby an oral surgeon. The second computer may be operated by a dentalspecialist including one or more of a periodontist, a prosthodontist, apedodontist, an orthodontic specialist, an oral and maxillofacialsurgery specialist, an oral and maxillofacial radiology specialist, anendodontist, and an oral and maxillofacial pathologist.

A method disclosed herein includes: seating a dental patient in aclinical office; acquiring a digital dental impression that may includethree-dimensional digital surface data for one or more intraoralstructures from an intraoral scan of the dental patient; transmittingthe digital dental impression to a dental laboratory before the patientleaves the office; receiving an evaluation of the digital dentalimpression from the dental laboratory before the patient leaves theoffice; and if the evaluation is unfavorable, repeating the step ofacquiring the digital dental impression.

If the evaluation includes an identification of at least one region ofthe one or more intraoral structures requiring additional preparation,the method may include preparing the one or more intraoral structuresaccording to the evaluation. The evaluation may include an evaluation ofsurface continuity, an evaluation of data density, or an evaluation offeature detail. The one or more intraoral structures may include a toothsurface prepared for a dental restoration. The digital dental impressionmay include a case plan for the restoration. The case plan may include atype of restoration, a design of restoration, or a list of restorationcomponents. The list of restoration components may include a fullceramic component. The list of restoration components may include a PFMcomponent. The case plan may include a specification of one or morerestoration materials.

A system disclosed herein includes: a means for acquiring a digitaldental impression, the digital dental impression may includethree-dimensional digital surface data for one or more intraoralstructures from an intraoral scan of a dental patient seated in aclinical office; a request means for transmitting the digital dentalimpression to a dental laboratory before the patient leaves the office;an evaluation means for determining if the digital dental impressionmust be reacquired before the patient leaves the office; and a responsemeans for transmitting the determination to the clinical office.

The evaluation means may include a means for evaluating surfacecontinuity, a means for evaluating data density, or a means forevaluating feature detail. The one or more intraoral structures mayinclude a tooth surface prepared for a dental restoration. The digitaldental impression may include a case plan for the restoration, a type ofrestoration, a design of restoration, or a list of restorationcomponents. The list of restoration components may include a fullceramic component. The list of restoration components may include a PFMcomponent. The case plan may include a specification of one or morerestoration materials.

A system disclosed herein includes: a scanning device for real timecapture of three-dimensional surface data; a monitor that may render thethree-dimensional surface data in real time; a processor that may beconfigure to evaluate quality of the three-dimensional surface data, andmay generate a signal representative of a data quality during a scan;and a feedback device that may be responsive to the signal to produce auser alert concerning the data quality when the data quality degradesbelow a predetermined threshold.

The scanning device may resolve the three-dimensional surface data froma plurality of two-dimensional image sets, and wherein the evaluation ofquality may include evaluation of ability to determine spatialrelationships from the plurality of two-dimensional image sets. Theevaluation of quality may include evaluation of point cloud density. Theevaluation of quality may include evaluation of scanning device motion.The feedback device may include an LED, a speaker, a buzzer, a vibrator,or a wand. The feedback device may be positioned on the wand. Thefeedback device may be further responsive to the signal to produce asecond user alert when the data quality is within an acceptable range.

In another aspect, a method disclosed in herein may include: schedulinga preparation visit for a dental restoration for a patient; obtaining adigital surface representation of one or more intraoral structures ofthe patient, this may include at least one tooth associated with thedental restoration; and fabricating a temporary restoration based uponthe digital surface representation.

Fabricating a temporary restoration may include transmitting the digitalsurface representation to a dental laboratory. Fabricating a temporaryrestoration may include applying the digital surface representation toprepare a design for the temporary restoration and transmitting thedesign to a dental laboratory. The method may includethree-dimensionally printing the temporary restoration. The method mayinclude three-dimensionally printing the temporary restoration at adentist's office where the preparation visit is scheduled. The methodmay include milling the temporary restoration. The method may includemilling the temporary restoration at a dental office where thepreparation visit is scheduled. Obtaining a digital surfacerepresentation may include three-dimensionally scanning the one or moreintraoral structures on a day of the preparation visit. Obtaining adigital surface representation may include retrieving the digitalsurface representation from prior dental data for the patient.Fabricating the temporary restoration may include fabricating thetemporary restoration prior to the preparation visit, the temporaryrestoration may include one or more characteristics of the at least onetooth. The method may include, on the day of the preparation visit,adapting a surface of the at least one tooth to receive the temporaryrestoration. The method may include, on the day of the preparationvisit, adapting the temporary restoration to fit a prepared surface ofthe at least one tooth. The step of fabricating may be performed at anin-house dental laboratory at a dentist's office.

A method disclosed herein includes: acquiring a digital dentalimpression including three-dimensional digital surface data for one ormore intraoral structures, the intraoral structures may include at leastone tooth surface prepared for a dental restoration; and acquiringadditional three-dimensional data with greater spatial resolution aroundthe at least one tooth surface prepared for the dental restoration.

The acquiring additional three-dimensional data may include acquiringadditional data from the at least one tooth surface, post-processingsource data for the digital dental impression, or post-processing thethree-dimensional digital surface data.

A computer program product disclosed herein includes computer executablecode embodied in a computer readable medium that, when executed on oneor more computer devices, may perform the steps of: acquiring one ormore images of one or more intraoral structures, the intraoralstructures may include at least one tooth surface prepared for a dentalrestoration; and generating a digital dental impression that may includethree-dimensional digital surface data from the one or more images.

The computer program product may include code that performs the step ofpost-processing source data for the digital dental impression togenerate additional three-dimensional data with greater spatialresolution. The computer program product may include code that performsthe step of post-processing the three-dimensional digital surface datato generate additional three-dimensional data with greater spatialresolution.

A system disclosed herein includes: a first means for acquiring adigital dental impression that may include three-dimensional digitalsurface data for one or more intraoral structures, the intraoralstructures may include at least one tooth surface prepared for a dentalrestoration; and a second means for acquiring additionalthree-dimensional data with greater spatial resolution around the atleast one tooth surface prepared for the dental restoration.

The second means may include a means for acquiring additional data fromthe at least one tooth surface, a means for post-processing source datafor the digital dental impression, or a means for post-processing thethree-dimensional digital surface data.

A method disclosed herein includes: acquiring a digital surfacerepresentation for one or more intraoral structures, the intraoralstructures may include at least one tooth surface prepared for a dentalrestoration; fabricating a kit from the digital surface representation,the kit may include two or more components suitable for use infabrication of the dental restoration; and sending the kit to a dentallaboratory for fabrication of the dental restoration. The kit mayinclude one or more of a die, a quad model, an opposing quad model, anopposing model, a base, a pre-articulated base, and a waxup.

The method may include transmitting the digital surface representationto a production facility. The step of fabricating may be performed atthe production facility. The kit may include one or more componentsselected from the group of pre-cut components, pre-indexed components,and pre-articulated components. The step of fabricating may be performedat a dentist's office.

An artificial dental object disclosed herein includes an exposedsurface, the exposed surface finished with a texture to enhanceacquisition of three dimensional image data from the exposed surfacewith a multi-aperture three-dimensional scanning device. The texture mayinclude pseudo-random three-dimensional noise.

The artificial dental object may include an impression coping, afixture, a healing abutment, or a temporary impression coping. Theartificial dental object may include a dental prosthesis, a dentalrestoration, a dental appliance, or an item of dental hardware.

In another aspect, a method disclosed herein includes acquiring athree-dimensional representation of one or more intraoral structures,the intraoral structures including at least one intraoral surfacesuitable for an artificial dental object; transmitting thethree-dimensional representation to a dental insurer; and receivingauthorization from the dental insurer to perform a dental procedureincluding the artificial dental object.

The artificial dental object may include one or more of an implant, acrown, an impression coping, a bridge, a fixture, and an abutment. Theintraoral surface may include at least one edentulous space. Theintraoral surface may include at least one tooth surface.

A computer program product disclosed herein may include code that, whenexecuted on one or more computer devices, performs the steps of:acquiring a three-dimensional representation of one or more intraoralstructures, the intraoral structures including at least one intraoralsurface suitable for an artificial dental object; transmitting thethree-dimensional representation to a dental insurer; and receivingauthorization from the dental insurer to perform a dental procedureincluding the artificial dental object.

The artificial dental object may include one or more of an implant, acrown, an impression coping, a fixture, a bridge, and an abutment. Theintraoral surface may include at least one edentulous space. Theintraoral surface may include at least one tooth surface.

A system disclosed herein includes a means for acquiring athree-dimensional representation of one or more intraoral structures,the intraoral structures including at least one intraoral surfacesuitable for an artificial dental object; a first communication meansfor transmitting the three-dimensional representation to a dentalinsurer; and a second communication means for receiving authorizationfrom the dental insurer to perform a dental procedure including theartificial dental object.

The artificial dental object may include one or more of an implant, acrown, an impression coping, a fixture, a bridge and an abutment. The atleast one intraoral surface may include an edentulous space. The atleast one intraoral surface includes a tooth surface.

In another aspect, a method disclosed herein includes acquiring athree-dimensional representation of one or more intraoral structures,the intraoral structures including at least one intraoral surfacerelated to a dental procedure; and transmitting the three-dimensionalrepresentation to a dental insurer as a record of the dental procedure.

The dental procedure may relate to one or more of an implant, a crown,an impression coping, a fixture, a bridge, and an abutment. The methodmay include receiving a payment from the insurer for a procedureinvolving the artificial dental object. The intraoral surface mayinclude an edentulous space. The intraoral surface may include a toothsurface prepared for an artificial dental object. The intraoral surfacemay include a restored tooth.

A computer program product disclosed herein includes computer executablecode embodied in a computer readable medium that, when executed on oneor more computer devices, performs the steps of: acquiring athree-dimensional representation of one or more intraoral structures,the intraoral structures including at one intraoral surface related to adental procedure; and transmitting the three-dimensional representationto a dental insurer as a record of the dental procedure.

The dental procedure may relate to one or more of an implant, a crown,an impression coping, a bridge, and an abutment. The code may furtherinclude code that performs the step of receiving a record of paymentfrom the insurer for the dental procedure. The intraoral surface mayinclude an edentulous space. The intraoral surface may include a toothsurface prepared for an artificial dental object. The intraoral surfacemay include a restored tooth.

A system disclosed herein may include a means for acquiring athree-dimensional representation of one or more intraoral structures,the intraoral structures including at least one intraoral surfacerelated to a dental procedure; and a communication means fortransmitting the three-dimensional representation to a dental insurer asa record of the dental procedure.

The dental procedure may to one or more of an implant, a crown, animpression coping, a bridge, and an abutment. The communication meansmay include a means for receiving a payment from the insurer for thedental procedure.

In another aspect, a method disclosed herein includes receiving athree-dimensional representation of one or more intraoral structuresfrom a dentist; receiving a proposed dental procedure from the dentist;determining whether the proposed dental procedure is appropriate for theone or more intraoral structures; and transmitting a reply to thedentist. The reply may include an approval to perform the dentalprocedure. The reply may include a denial to perform the dentalprocedure. The method may include authorizing payment for the dentalprocedure.

A computer program product disclosed herein includes computer executablecode embodied in a computer readable medium that, when executed on oneor more computer devices, may perform the steps of: receiving athree-dimensional representation of one or more intraoral structuresfrom a dentist; receiving a proposed dental procedure from the dentist;comparing the proposed dental procedure to a predetermined list ofappropriate procedures for the one or more intraoral structures; andtransmitting a reply to the dentist. The reply may include an approvalto perform the dental procedure. The reply may include a denial toperform the dental procedure. The computer program product may includecomputer code that performs the step of authorizing payment for thedental procedure.

A system disclosed herein includes: a first means for receiving athree-dimensional representation of one or more intraoral structuresfrom a dentist; a second means for receiving a proposed dental procedurefrom the dentist; an evaluation means for determining whether theproposed dental procedure is appropriate for the one or more intraoralstructures; and a reply means for transmitting a reply to the dentist.The reply may include an approval to perform the dental procedure. Thereply may include a denial to perform the dental procedure. The systemmay include a means for authorizing payment for the dental procedure.

A system disclosed herein includes: a dental data repository coupled toa communications network, the dental data repository may be adapted toreceive dental data including three-dimensional representations ofintraoral structures and prescriptions for dental procedures from aplurality of dentists.

The dental data repository may be adapted to transmit prescriptions andthree-dimensional representations to a plurality of dental laboratories.The at least one of the prescriptions may identify a specific one of theplurality of dental laboratories. The dental data repository may befurther adapted to communicate with one or more dental insurers forauthorization of dental procedures. The dental data repository may befurther adapted to communicate with one or more dental insurers tocoordinate payment for dental procedures. The system may include adental laboratory interface for the plurality of dental laboratories toprovide status on work in progress. The system may include a dentallaboratory interface for the plurality of dental laboratories to receivework assignments. The system may include a dentist interface for theplurality of dentists to monitor work in progress. The system mayinclude a dentist interface for the plurality of dentists to submitprescriptions and three-dimensional representations. The system mayinclude a transaction engine for transmitting payments among two or moreof one of the plurality of dentists, one of the plurality of dentallaboratories, and one of the one or more dental insurers. The system mayinclude a collaboration interface for two or more of the plurality ofdentists to collaborate on a dental matter.

BRIEF DESCRIPTION OF THE FIGURES

The invention and the following detailed description of certainembodiments thereof may be understood by reference to the followingfigures.

FIG. 1 shows a dental image capture system.

FIG. 2 shows entities participating in a digital dentistry network.

FIG. 3 shows a user interface that may be used in a digital dentalsystem.

FIG. 4 depicts a quality control procedure for use in a digital dentalsystem.

FIG. 5 shows a dental laboratory procedure using a digital dental model.

FIG. 6 illustrates a scan path that may be used with a three-dimensionalimage capture system.

FIGS. 7A and 7B show a modeling environment for creating alignmentguides for orthodontic hardware.

DETAILED DESCRIPTION

Described are a wide array of systems and methods for digital dentistry.However, it will be appreciated that the inventive concepts disclosedherein are not limited to the specific embodiments disclosed. Forexample, the general techniques disclosed herein may be usefullyemployed in any environment where precise, three-dimensional data mightbe usefully captured and processed, including orthopedics, digitalanimation, and customized manufacturing. In addition, while numerousvariations and implementations of digital dentistry techniques aredescribed, it will be appreciated that other combinations of thespecific scanning, processing, and manufacturing techniques describedherein may be used, and that such variations are intended to fall withinthe scope of this disclosure.

In the following description, the term “image” generally refers to atwo-dimensional set of pixels forming a two-dimensional view of asubject within an image plane. The term “image set” generally refers toa set of related two dimensional images that might be resolved intothree-dimensional data. The term “point cloud” generally refers to athree-dimensional set of points forming a three-dimensional view of thesubject reconstructed from a number of two-dimensional views. In athree-dimensional image capture system, a number of such point cloudsmay also be registered and combined into an aggregate point cloudconstructed from images captured by a moving camera. Thus it will beunderstood that pixels generally refer to two-dimensional data andpoints generally refer to three-dimensional data, unless another meaningis specifically indicated or clear from the context.

The terms “three-dimensional surface representation”, “digital surfacerepresentation”, “three-dimensional surface map”, and the like, as usedherein, are intended to refer to any three-dimensional surface map of anobject, such as a point cloud of surface data, a set of two-dimensionalpolygons, or any other data representing all or some of the surface ofan object, as might be obtained through the capture and/or processing ofthree-dimensional scan data, unless a different meaning is explicitlyprovided or otherwise clear from the context.

A “three-dimensional representation” may include any of thethree-dimensional surface representations described above, as well asvolumetric and other representations, unless a different meaning isexplicitly provided or otherwise clear from the context.

In general, the terms “render” or “rendering” refer to a two-dimensionalvisualization of a three-dimensional object, such as for display on amonitor. However, it will be understood that three-dimensional renderingtechnologies exist, and may be usefully employed with the systems andmethods disclosed herein. As such, rendering should be interpretedbroadly unless a narrower meaning is explicitly provided or otherwiseclear from the context.

The term “dental object”, as used herein, is intended to refer broadlyto subject matter specific to dentistry. This may include intraoralstructures such as dentition, and more typically human dentition, suchas individual teeth, quadrants, full arches, pairs of arches which maybe separate or in occlusion of various types, soft tissue (e.g.,gingival and mucosal surfaces of the mouth, or perioral structures suchas the lips, nose, cheeks, and chin), and the like, as well bones andany other supporting or surrounding structures. As used herein, the term“intraoral structures” refers to both natural structures within a mouthas described above and artificial structures such as any of the dentalobjects described below. While the design and fabrication of artificialdental structures is the subject of much of the following discussion, itwill be understood that any of these artificial structures might bepresent in the mouth during a scan, either as a result of prior dentalwork (e.g., a previously restored tooth) or during an evaluation of fitand other aspects of a current procedure. Dental objects may include“restorations”, which may be generally understood to include componentsthat restore the structure or function of existing dentition, such ascrowns, bridges, veneers, inlays, onlays, amalgams, composites, andvarious substructures such as copings and the like, as well as temporaryrestorations for use while a permanent restoration is being fabricated.Dental objects may also include a “prosthesis” that replaces dentitionwith removable or permanent structures, such as dentures, partialdentures, implants, retained dentures, and the like. Dental objects mayalso include “appliances” used to correct, align, or otherwisetemporarily or permanently adjust dentition, such as removableorthodontic appliances, surgical stents, bruxism appliances, snoreguards, indirect bracket placement appliances, and the like. Dentalobjects may also include “hardware” affixed to dentition for an extendedperiod, such as implant fixtures, implant abutments, orthodonticbrackets, and other orthodontic components. Dental objects may alsoinclude “interim components” of dental manufacture such as dental models(full and/or partial), wax-ups, investment molds, and the like, as wellas trays, bases, dies, and other components employed in the fabricationof restorations, prostheses, and the like. As suggested above, dentalobjects may also be categorized as natural dental objects such as theteeth, bone, and other intraoral structures described above or asartificial dental objects such as the restorations, prostheses,appliances, hardware, and interim components of dental manufacture asdescribed above. It will be understood that any of the foregoing,whether natural or artificial, may be an intraoral structure whenpresent within the mouth. Thus, for example, a previous restoration oran implant for a crown might be present within the mouth, and may be anintraoral structure scanned during an intraoral scan.

Terms such as “digital dental model”, “digital dental impression” andthe like, are intended to refer to three-dimensional representations ofdental objects that may be used in various aspects of acquisition,analysis, prescription, and manufacture, unless a different meaning isotherwise provided or clear from the context. Terms such as “dentalmodel” or “dental impression” are intended to refer to a physical model,such as a cast, printed, or otherwise fabricated physical instance of adental object. Unless specified, the term “model”, when used alone, mayrefer to either or both of a physical model and a digital model.

FIG. 1 shows an image capture system. In general, the system 100 mayinclude a scanner 102 that captures images from a surface 106 of asubject 104, such as a dental patient, and forwards the images to acomputer 108, which may include a display 110 and one or more user inputdevices such as a mouse 112 or a keyboard 114. The scanner 102 may alsoinclude an input or output device 116 such as a control input (e.g.,button, touchpad, thumbwheel, etc.) or a status indicator (e.g., LCD orLED display or light, a buzzer, or the like) to provide statusinformation.

The scanner 102 may include any camera or camera system suitable forcapturing images from which a three-dimensional point cloud may berecovered. For example, the scanner 102 may employ a multi-aperturesystem as disclosed, for example, in U.S. Pat. Pub. No. 20040155975 toHart et al., the entire contents of which is incorporated herein byreference. While Hart discloses one multi-aperture system, it will beappreciated that any multi-aperture system suitable for reconstructing athree-dimensional point cloud from a number of two-dimensional imagesmay similarly be employed. In one multi-aperture embodiment, the scanner102 may include a plurality of apertures including a center aperturepositioned along a center optical axis of a lens and any associatedimaging hardware. The scanner 102 may also, or instead, include astereoscopic, triscopic or other multi-camera or other configuration inwhich a number of cameras or optical paths are maintained in fixedrelation to one another to obtain two-dimensional images of an objectfrom a number of slightly different perspectives. The scanner 102 mayinclude suitable processing for deriving a three-dimensional point cloudfrom an image set or a number of image sets, or each two-dimensionalimage set may be transmitted to an external processor such as containedin the computer 108 described below. In other embodiments, the scanner102 may employ structured light, laser scanning, direct ranging, or anyother technology suitable for acquiring three-dimensional data, ortwo-dimensional data that can be resolved into three-dimensional data.

In one embodiment, a second scanner such as a PMD[vision] camera fromPMD Technologies, may be employed to capture real-time,three-dimensional data on dynamic articulation and occlusion. While thisscanner employs different imaging technology (time-of-flight detectionfrom an array of LEDs) than described above, and produces results withresolution generally unsuitable for reconstruction of dental models,such a scanner may be employed to infer motion of, e.g., opposing dentalarches with sufficient resolution to select an axis for articulation orotherwise capture dynamic information that can be applied to two or morerigid bodies of a dental object scan. This data may be supplemented withmore precise alignment data statically captured from digital or manualbite registration to provide reference or calibration points forcontinuous, dynamic motion data.

In one embodiment, the scanner 102 is a handheld, freely positionableprobe having at least one user input device 116, such as a button,lever, dial, thumb wheel, switch, track ball, mini joystick, touchpad,keypad, or the like, for user control of the image capture system 100such as starting and stopping scans, or interacting with a userinterface on the display 110. In an embodiment, the scanner 102 may beshaped and sized for dental scanning. More particularly, the scanner 102may be shaped and sized for intraoral scanning and data capture, such asby insertion into a mouth of an imaging subject and passing over anintraoral surface 106 at a suitable distance to acquire surface datafrom teeth, gums, and so forth. This may include a shape resembling anelectric toothbrush or a dental tool, and including an elongated bodywith an optical port on one end that receives scan data, and usercontrols on (or near) the other end.

A physical offset may be provided for the optical port that physicallymaintains an appropriate distance from scanning subject matter. Moreparticularly, the physical offset may prevent the optical port fromgetting too near the scanned subject matter, which permits a user tomaintain proper distance through a steady application of pressure towardthe subject matter. The physical offset may be adapted for particularsubject matter and may include a simple rod or other rigid formextending toward the optical path of the scanner, or the physical offsetmay include contoured forms for mating with more complex surfaces. Thephysical offset may include wheels or plates for slidably engaging asurface of scanned subject matter, or other structures or surfacetreatments to improve operation in various applications.

The scanner 102 may, through a continuous acquisition process, capture apoint cloud of surface data having sufficient spatial resolution andaccuracy to prepare dental objects such as restorations, hardware,appliances, and the like therefrom, either directly or through a varietyof intermediate processing steps. In other embodiments, surface data maybe acquired from a dental model such as a dental restoration, to ensureproper fitting using a previous scan of corresponding dentition, such asa tooth surface prepared for the restoration.

Although not shown in FIG. 1, it will be appreciated that a number ofsupplemental lighting systems may be usefully employed during imagecapture. For example, environmental illumination may be enhanced withone or more spotlights illuminating the subject 104 to speed imageacquisition and improve depth of field (or spatial resolution depth).The scanner 102 may also, or instead, include a strobe, flash, or otherlight source to supplement illumination of the subject 104 during imageacquisition.

The subject 104 may be any object, collection of objects, portion of anobject, or other subject matter. More particularly with respect to thedental fabrication techniques discussed herein, the object 104 mayinclude human dentition captured intraorally from a dental patient'smouth. A scan may capture a three-dimensional representation of some orall of the dentition according to particular purpose of the scan. Thusthe scan may capture a digital model of a tooth, a quadrant of teeth, ora full collection of teeth including two opposing arches, as well assoft tissue or any other relevant intraoral and/or extraoral structures.In other embodiments where, for example, a completed fabrication isbeing virtually test fit to a surface preparation, the scan may includea dental restoration such as an inlay or a crown, or any otherartificial dental object. The subject 104 may also, or instead, includea dental model, such as a plaster cast, wax-up, impression, or negativeimpression of a tooth, teeth, soft tissue, or some combination of these.

Although not depicted, it will be understood that the scanner 102 mayhave a two-dimensional field of view or image plane where optical datais acquired. It will be appreciated that the term “image plane” as usedin this paragraph, refers to a plane in the imaging environment ratherthan a plane within an optical sensor (such as film or sensors) where animage is captured. The image plane may form any number oftwo-dimensional shapes according to the construction of the scanner 102,such as a rectangle, a square, a circle, or any other two-dimensionalgeometry. In general, the scanner 102 will have a depth of field orrange of depth resolution for image acquisition within the image planedetermined by the physical construction of the scanner 102 andenvironmental conditions such as ambient light.

The computer 108 may be, for example, a personal computer or otherprocessing device. In one embodiment, the computer 108 includes apersonal computer with a dual 2.8 GHz Opteron central processing unit, 2gigabytes of random access memory, a TYAN Thunder K8WE motherboard, anda 250 gigabyte, 10,000 rpm hard drive. This system may be operated tocapture approximately 1,500 points per image set in real time using thetechniques described herein, and store an aggregated point cloud of overone million points. As used herein, the term “real time” means generallywith no observable latency between processing and display. In avideo-based scanning system, real time more specifically refers toprocessing within the time between frames of video data, which typicallyvary according to specific video technologies between about fifteenframes per second and about thirty frames per second. However, it willalso be understood that terms such as “video” or “video rate” imply awide range of possible frame rates associated with such video. Whilemost modern video formats employ a frame rate of 25 to 30 frames persecond, early video employed frame rates as low as 8 frames per second,and movies of the early 1900's varied from 12 to 18 frames per second.In addition, it is common for specialized imaging equipment to employ arate adapted to the computational demands of particular imaging andrendering techniques, and some video systems operate with frame ratesanywhere from 4 frames per second (for computationally extensive imagingsystems) to 100 frames per second or higher (for high-speed videosystems). As used herein, the terms video rate and frame rate should beinterpreted broadly. Notwithstanding this broad meaning, it is notedthat useful and visually pleasing three-dimensional imaging systems maybe constructed as described herein with frame rates of at least tenframes per second, frame rates of at least twenty frames per second, andframe rates between 25 and 30 frames per second.

More generally, processing capabilities of the computer 108 may varyaccording to the size of the subject 104, the speed of imageacquisition, and the desired spatial resolution of three-dimensionalpoints. The computer 108 may also include peripheral devices such as akeyboard 114, display 110, and mouse 112 for user interaction with thecamera system 100. The display 110 may be a touch screen display capableof receiving user input through direct, physical interaction with thedisplay 110.

Communications between the computer 108 and the scanner 102 may use anysuitable communications link including, for example, a wired connectionor a wireless connection based upon, for example, IEEE 802.11 (alsoknown as wireless Ethernet), BlueTooth, or any other suitable wirelessstandard using, e.g., a radio frequency, infrared, or other wirelesscommunication medium. In medical imaging or other sensitiveapplications, wireless image transmission from the scanner 102 to thecomputer 108 may be secured. The computer 108 may generate controlsignals to the scanner 102 which, in addition to image acquisitioncommands, may include conventional camera controls such as focus orzoom. In addition, the computer 108 may include a network communicationsinterface for connecting to a network such as the dental networkdescribed below.

In an example of general operation of a three-dimensional image capturesystem 100, the scanner 102 may acquire two-dimensional image sets at avideo rate while the scanner 102 is passed over a surface of thesubject. The two-dimensional image sets may be forwarded to the computer108 for derivation of three-dimensional point clouds. Thethree-dimensional data for each newly acquired two-dimensional image setmay be derived and fitted or “stitched” to existing three-dimensionaldata using a number of different techniques. Such a system employscamera motion estimation to avoid the need for independent tracking ofthe position of the scanner 102. One useful example of such a techniqueis described in commonly-owned U.S. application Ser. No. 11/270,135,filed on Nov. 9, 2005, the entire contents of which is incorporatedherein by reference. However, it will be appreciated that this exampleis not limiting, and that the principles described herein may be appliedto a wide range of three-dimensional image capture systems.

The display 110 may include any display suitable for video or other raterendering at a level of detail corresponding to the acquired data.Suitable displays include cathode ray tube displays, liquid crystaldisplays, light emitting diode displays and the like. In addition, wherethree-dimensional visualization is desired, the display 110 may includea three-dimensional display using a wide variety of techniques includingstereo pair imaging, holographic imaging, and multiplanar or volumetricimaging, each with a number of rendering modalities that may be usefullyemployed with the systems described herein.

In some embodiments, the display may include a touch screen interfaceusing, for example capacitive, resistive, or surface acoustic wave (alsoreferred to as dispersive signal) touch screen technologies, or anyother suitable technology for sensing physical interaction with thedisplay 110.

The touch screen may be usefully employed in a dental office or othercontext to provide keyboardless processing and manipulation of scanningand any resulting three-dimensional representations. For example, thetouch screen may be employed to permit user manipulation of a displayedmodel, such as panning, zooming, and rotating, through direct physicalinteraction with the displayed model and any corresponding controlswithin a user interface. For example, a user may touch a “rotate” buttonon the display 110, after which placing a finger on the screen anddragging may cause three-dimensional rotation of the displayed modelaround a corresponding axis (typically perpendicular to the direction offinger motion).

The touch screen may also provide tools for manipulating the digitalmodel. For example, a user may define or specify a cementation void ordie spacer. A user may define, edit, or annotate a margin line, such asa computer-generated margin line. A user may define a die and/or ditch adie by recessing one or more regions below the margin line. A user mayplace arches of a digital dental model into a virtual articulator andarticulate the arches. The touch screen may provide one or more toolsfor virtually designing a dental restoration fitted to a dental model,including fitting to a prepared surface, adjacent teeth, and/or teeth ofan opposing arch.

The touch screen may also provide case management controls providingfunctions such as transmitting a digital model to a dental laboratory,evaluating quality of a digital model or performing other qualitycontrol functions as described below, or creating a dental prescriptionas described, for example, below with reference to FIG. 3.

The image capture system 100 may generally be adapted for real timeacquisition and display, e.g., at a video rate, of three-dimensionaldata, which may be rendered, for example, as a point cloud superimposedon a video image from the scanner 102. For certain types of dataacquisition, there may be a significant difference in the processingtime required for resolution of a three-dimensional image adequate fortwo-dimensional perspective rendering (faster) and maximum or optimumresolution that might be achieved with post-processing. In suchcircumstances, the image capture system 100 may include two differentoperating modes. In a first operating mode, a relatively low-qualitythree-dimensional representation may be obtained and rendered in realtime, such as within the display 110. In a second operating mode, arelatively high-quality three-dimensional representation may begenerated for the source scan data using any desired degree ofprocessing. The second operating mode may recover, through additionalpost-processing steps, three-dimensional data having greater spatialresolution and/or accuracy. It will be understood that, while twodifferent modes are described, it is not required that the two modes bemutually exclusive. For example, both modes may execute simultaneouslyon a computer as separate processes or threads, or the data from thefirst operating mode may be employed to seed the second operating modewith a model for refinement for post-processing. All such variations aswould be apparent to one of ordinary skill in the art may be employedwith the systems described herein. Either the high-qualityrepresentation or the low-quality representation, or both, may betransmitted to a dental laboratory for subsequent steps such as qualitycontrol and model fabrication, examples of which are provided below.

In another aspect, the system 100 may provide different levels ofaccuracy or spatial resolution, each associated with, for example,different degrees of post-processing, computing power, or rate ofmovement by the scanner 102 over a subject 104. Thus, for example, anentire dental arch may be scanned at a relatively low accuracy, while asurface preparation or other area of diagnostic or treatmentsignificance may be scanned at a relatively higher accuracy which may,for example, require a slower scanning motion or additionalpost-processing delays. Similarly, certain areas such as the surfacepreparation may be designated for supplemental post-processing toachieve enhanced accuracy or spatial resolution.

The input or output device 116 may include a feedback device thatprovides warnings or indicators to an operator of the image capturesystem 100 with respect to scan quality or progress. The device 116 mayinclude, for example, a buzzer, speaker, light emitting diode, anincandescent light, or any other acoustic, haptic, tactile, or visualsignal to notify the operator of an event without requiring the operatorto look at the display 110. For example, data quality may becontinuously monitored by the system 100, and an alert may be generatedwhen the data quality drops below a quantitative threshold, or dataacquisition is lost completely (or different alerts may be provided foreach of these events). The evaluation of data quality may depend, forexample, on an ability of the system 100 to fit a new data set toexisting three-dimensional data, or the ability to resolvetwo-dimensional image sets into three-dimensional data, or the densityof acquired data, or any other objective criterion, either alone or incombination. The evaluation of data quality may also, or instead, beinferred from other parameters such as motion of the scanner 102 ordistance from the subject 104. It will be understood that while a dataquality indicator may be positioned on the scanner 102 as shown, thedevice 116 may also, or instead, be positioned at any other locationsuitable for alerting an operator, which may depend on the type of alertgenerated (i.e., a visual alert may have different positioningparameters than an audio alert or a tactile alert). In another aspect,the input or output device 116 may provide feedback when data quality iswithin an acceptable range. In another aspect, the input our outputdevice 116 may provide both positive feedback (good data quality) andnegative feedback (poor data quality) so that continuous feedback isavailable to the operator concerning an ongoing scan.

FIG. 2 shows entities participating in a digital dentistry network. Asdepicted, a network 200 may include a plurality of clients 202 andservers 204 connected via an internetwork 210. Any number of clients 202and servers 204 may participate in such a system 200. The network 200may include one or more local area networks (“LANs”) 212 interconnectingclients 202 through a hub 214 (in, for example, a peer network such as awired or wireless Ethernet network) or a local area network server 214(in, for example, a client-server network). The LAN 212 may be connectedto the internetwork 210 through a gateway 216, which provides securityto the LAN 212 and ensures operating compatibility between the LAN 212and the internetwork 210. Any data network may be used as theinternetwork 210 and the LAN 212.

The internetwork 210 may include, for example, the Internet, with theWorld Wide Web providing a system for interconnecting clients 202 andservers 204 in a communicating relationship through the internetwork210. The internetwork 210 may also, or instead, include a cable network,a satellite network, the Public Switched Telephone Network, a WiFinetwork, a WiMax network, cellular networks, and any other public,private, and/or dedicated networks, either alone or combination, thatmight be used to interconnect devices for communications and transfer ofdata.

An exemplary client 202 may include a processor, a memory (e.g. RAM), abus which couples the processor and the memory, a mass storage device(e.g. a magnetic hard disk or an optical storage disk) coupled to theprocessor and the memory through an I/O controller, and a networkinterface coupled to the processor and the memory, such as modem,digital subscriber line (“DSL”) card, cable modem, network interfacecard, wireless network card, or other interface device capable of wired,fiber optic, or wireless data communications. One example of such aclient 202 is a personal computer equipped with an operating system suchas Microsoft Windows XP, UNIX, or Linux, along with software support forInternet and other communication protocols. The personal computer mayalso include a browser program, such as Microsoft Internet Explorer,Netscape Navigator, or FireFox to provide a user interface for access tothe internetwork 210. Although the personal computer is a typical client202, the client 202 may also be a workstation, mobile computer, Webphone, VoIP device, television set-top box, interactive kiosk, personaldigital assistant, wireless electronic mail device, or other devicecapable of communicating over the Internet. As used herein, the term“client” is intended to refer to any of the above-described clients 202or other client devices, and the term “browser” is intended to refer toany of the above browser programs or other software or firmwareproviding a user interface for navigating through an internetwork 210such as the Internet. The client 202 may also include variouscommunications capabilities such as instant messaging, electronic mail,syndication (such as RSS 2.0), Web-based conferencing, Web-basedapplication sharing, Web-based videoconferencing, Voice over IP(“VoIP”), and any other standards-based, proprietary, or othercommunication technologies, either in hardware, software, or acombination of these, to enable communications with other clients 202through the internetwork 210.

An exemplary server 204 includes a processor, a memory (e.g. RAM), a buswhich couples the processor and the memory, a mass storage device (e.g.a magnetic or optical disk) coupled to the processor and the memorythrough an I/O controller, and a network interface coupled to theprocessor and the memory. Servers may be clustered together to handlemore client traffic, and may include separate servers for differentfunctions such as a database server, an application server, and a Webpresentation server. Such servers may further include one or more massstorage devices 206 such as a disk farm or a redundant array ofindependent disk (“RAID”) system for additional storage and dataintegrity. Read-only devices, such as compact disk drives and digitalversatile disk drives, tape drives, and the like may also be connectedto the servers. Suitable servers and mass storage devices aremanufactured by, for example, IBM, and Sun Microsystems. Generally, aserver 204 may operate as a source of content, a hub for interactionsamong various clients, and platform for any back-end processing, while aclient 202 is a participant in the dental activities supported by thedigital dentistry systems described herein. However, it should beappreciated that many of the devices described above may be configuredto respond to remote requests, thus operating as a server, and thedevices described as servers 204 may participate as a client in variousdigital dentistry applications.

Focusing now on the internetwork 210, one embodiment is the Internet.The structure of the Internet 210 is well known to those of ordinaryskill in the art and includes a network backbone with networks branchingfrom the backbone. These branches, in turn, have networks branching fromthem, and so on. The backbone and branches are connected by routers,bridges, switches, and other switching elements that operate to directdata through the internetwork 210. For a more detailed description ofthe structure and operation of the Internet 210, one may refer to “TheInternet Complete Reference,” by Harley Hahn and Rick Stout, publishedby McGraw-Hill, 1994. However, one may practice the present invention ona wide variety of communication networks. For example, the internetwork210 can include interactive television networks, telephone networks,wireless voice or data transmission systems, two-way cable systems,customized computer networks, Asynchronous Transfer Mode networks, andso on. Clients 202 may access the internetwork 210 through an InternetService Provider (“ISP”, not shown) or through a dedicated DSL service,ISDN leased lines, T1 lines, OC3 lines, digital satellite service, cablemodem service, or any other connection, or through an ISP providingsame. Further, the internetwork 210 may include a variety of networktypes including wide-area networks, local area networks, campus areanetworks, metropolitan area networks, and corporate area networks.

In an exemplary embodiment, a browser, executing on one of the clients202, retrieves a Web document at an address from one of the servers 204via the internetwork 210, and displays the Web document on a viewingdevice, e.g., a screen. A user can retrieve and view the Web document byentering, or selecting a link to, a URL in the browser. The browser thensends an http request to the server 204 that has the Web documentassociated with the URL. The server 204 responds to the http request bysending the requested Web document to the client 202. The Web documentis an HTTP object that includes plain text (ASCII) conforming to theHyperText Markup Language (“HTML”). Other markup languages are known andmay be used on appropriately enabled browsers and servers, including theDynamic HyperText Markup Language (“DHTML”), the Extensible MarkupLanguage (“XML”), the Extensible Hypertext Markup Language (“XHML”), andthe Standard Generalized Markup Language (“SGML”).

Each Web document usually contains hyperlinks to other Web documents.The browser displays the Web document on the screen for the user and thehyperlinks to other Web documents are emphasized in some fashion suchthat the user can identify and select each hyperlink. To enhancefunctionality, a server 204 may execute programs associated with Webdocuments using programming or scripting languages, such as Perl, C,C++, C#, or Java, or a Common Gateway Interface (“CGI”) script to accessapplications on the server. A server 204 may also use server-sidescripting languages such as ColdFusion from MacroMedia or PHP. Theseprograms and languages may perform “back-end” functions such as orderprocessing, database management, and content searching. A Web documentmay also contain, or include references to, small client-sideapplications, or applets, that are transferred from the server 204 tothe client 202 along with a Web document and executed locally by theclient 202. Java is one popular example of a programming language usedfor applets. The text within a Web document may further include(non-displayed) scripts that are executable by an appropriately enabledbrowser, using a scripting language such as JavaScript or Visual BasicScript. Browsers may further be enhanced with a variety of helperapplications to interpret various media including still image formatssuch as JPEG and GIF, document formats such as PS and PDF, motionpicture formats such as AVI and MPEG, animated media such as Flashmedia, and sound formats such as MP3 and MIDI. These media formats,along with a growing variety of proprietary media formats, may be usedto enrich a user's interactive and audio-visual experience as each Webdocument is presented through the browser. In addition, user interactionmay be supplemented with technologies such as RSS (for syndication),OPML (for outlining), AJAX (for dynamic control of a web page), and soforth. The term “page” as used herein is intended to refer to the Webdocument described above, as well as any of the above-describedfunctional or multimedia content associated with the Web document. Apage may be employed to provide a user interface to the digitaldentistry systems described herein. In addition, one or moreapplications running on a client 202 may provide a user interface forlocal and/or networked digital dentistry functions as described herein.

In FIG. 2, each client 202 represents a computing device coupled to theinternetwork 210. It will be understood that a client 202 may be presentat a location associated with digital dentistry such as a dentallaboratory, a rapid manufacturing facility, a dental office, and/or adental data center. Each of these potential participants in a digitaldentistry system will now be described in greater detail.

One of the clients 202 may reside at a dental office. The dental officemay include any office or other physical facility that provides dentalcare including individual dentist offices, dental group offices, retaildental centers, university dental schools, and the like. A dentalpatient may visit the dental office for a routine check up or cleaning,or for a visit scheduled due to oral discomfort, dental injury, or thelike.

During the dental visit, a dentist may examine the dental patient andprovide a dental assessment, such as the need for a restoration, toothextraction, or the like. The dental office may include athree-dimensional scanner, such as any of the scanners described above,which the dentist may use to capture a three-dimensional digitalrepresentation of the dental patient's dentition including scans bothbefore and after one or more tooth surfaces have been prepared for adental object such as a restoration or the like. While a scan may beperformed in the context of a specific dental issue, such as a plannedrestoration, the dentist may also capture scans during routine visits sothat a dental history for the dental patient is accumulated over time.Using the client 202, which may include the image capture system 100described above, the dentist may obtain one or more three-dimensionalrepresentations and, after discussing treatment with the dental patient,input any relevant dental prescription information. The dentist may thenelectronically transmit the three-dimensional representations, alongwith the prescription, to a dental laboratory or other fabricationfacility using a network such as the internetwork 210 described above.In general, an electronic dental prescription, as used herein, includesa dental prescription in electronic form along with anythree-dimensional data such as tooth surfaces before and after surfacepreparation, teeth in occlusion, and so forth. Additional data, such asx-ray, digital radiographic, or photograph data may be incorporated intothe electronic dental prescription, or otherwise used with the systemsand methods described herein. In certain instances, an electronic dentalprescription may instead refer exclusively to the prescription data. Ingeneral, the meaning should be clear from the context, however, in theabsence of explicit guidance, the broadest possible meaning is intended.

As a significant advantage, a practicing dentist may maintain a historyof three-dimensional representations of dentition and surrounding softtissue for each dental patient. Where a new procedure, such as arestoration, is scheduled for the patient, the dentist may pre-fabricatea temporary restoration using historic dental data. The temporaryrestoration may be fabricated for example, at the dental office wherethe procedure is scheduled using a three-dimensional printer and/or acopy milling machine, or at a remote facility such as the dentallaboratory or rapid manufacturing facility described below. In oneaspect, a scan may be obtained of a prepared surface during thescheduled visit, and the temporary restoration (or a final restoration)may be fabricated, such as at the dental office during the visit, bycombining historical three-dimensional data with a three-dimensionalrepresentation of the prepared surface. In another embodiment, atreating dentist may shape the surface preparation to receive apre-fabricated temporary restoration.

More generally, the client 202 at the dental office may be coupled in acommunicating relationship with a client 202 at one or more of a dentallaboratory, another dental office, a rapid manufacturing facility,and/or a dental data center for communication of three-dimensionalrepresentations of dental subject matter and related information. Thisdental network may be usefully employed in diagnosis, case planning,consultation, evaluation, and the like. Participation may include, forexample, consultation, online or distance collaboration, approval,payment authorization, or any other collaborative or unilateralparticipation, examples of which are provided throughout thisdescription. Thus there is disclosed herein methods and systems forsharing digital dental data, such as digital dental impressions capturedusing the techniques described above. This may permit a wide array ofcollaborative communications using a shared view of dentition or relateddigital models. For example, a dentist may collaborate with anotherdentist, a dental technician at a dental laboratory, an oral surgeon, atechnician at a rapid manufacturing facility, or any other participantin a dental network at a remote location using a shared view of apatient's dentition. Various dental specialists may participate fromremote (or local) locations, such as a periodontist, a prosthodontist, apedodontist, an orthodontic specialist, an oral and maxillofacialsurgery specialist, an oral and maxillofacial radiology specialist, anendodontist, and/or an oral and maxillofacial pathologist. Tools may beprovided, such as collaborative tools, for sharing control of modelmanipulation, sectioning, rearranging, marking, and visualizing orsimulating proposed clinical procedures. Each participant may view arendering of the three-dimensional representation of dentition from acommon or shared point of view. Control of the view and any modelingtools may be passed among participants, as well as a cursor or commandprompt shared by participants within a user interface. In one aspect,this system forms a collaborative dental environment in which athree-dimensional representation of a dental patient's dentition isshared among participants. Communications among participants may includeany network-supported communications protocol including electronic mail,instant messaging, Internet Relay Chat, Voice-over-IP, and the like, aswell as conventional teleconferencing.

Turning next to the dental laboratory, a dental laboratory may provide afabrication resource for dental practitioners. A conventional dentallaboratory may have a number of production departments specializing invarious dental objects such as complete dentures, partial dentures,crowns and bridges, ceramics, and orthodontic appliances. A dentallaboratory may employ trained technicians to perform various tasksassociated with filling a dental prescription such as preparing dentalmodels, dies, articulated models, and the like from impressions andocclusal registrations received from dentists. Typically, a dentistsubmits an order with specific instructions (a prescription) to a dentallaboratory, and the laboratory fabricates the corresponding dentalobject(s) for use by the dentist. A client 202 at a dental laboratorymay be coupled in a communicating relationship with a client 202 at oneor more of a dental office, another dental laboratory, a rapidmanufacturing facility, and/or a dental data center for communication ofthree-dimensional representations of dental subject matter and relatedinformation. This dental network may be usefully employed in diagnosis,case planning, consultation, evaluation, and the like.

Dental laboratories may for example create restorative products such ascrowns and bridges. A traditional crown formed of gold, other metalalloys, or ceramic may replace all visible areas of a tooth. An onlay isa partial crown that does not fully cover the visible tooth. Crowns mayinclude a precision attachment incorporated into the design that mayreceive and connect a removable partial denture. Inlays are restorationsfabricated to fit a prepared tooth cavity and then cemented into place.A bridge is a restoration of one or more missing teeth, such as a fixedpartial, a three unit bridge, or the like. A bridge may be permanentlyattached to the natural teeth or attached to custom-made orprefabricated posts and cores that are first cemented into the roots.

Another major area of dental objects includes reconstructive products,most typically dentures. Partial dentures are a removable dentalprosthesis that replaces missing teeth and associated structures. Fulldentures substitute for the total loss of teeth and associatedstructures. Some dental labs also make precision attachments thatconnect a crown to an artificial prosthesis. Implants are fixturesanchored securely in the bone of the mouth to which an abutment, crownor other dental object can be attached using screws, clips, or the like.This may include, for example, a titanium root replacement integratedwith the bone, an abutment or transfer coping, and an implant secured tothe abutment. Implant procedures also typically involve a healingabutment to assist with healing of affected soft tissue and to maintainpositioning of teeth while the root replacement attaches to the bone(which may take several months). An additional impression may be takenof the implant using an impression coping or abutment after it hasattached to the bone for preparation of a final restoration.

A dental laboratory may also manufacture cosmetic products such asceramic or composite resin veneers and crowns. Veneers are thincoverings cemented to the front of the tooth for aesthetic affect.Crowns are designed to cover the entire tooth preparation and willresemble natural teeth. Composite or ceramic inlays and onlays may bemanufactured to replace amalgams and give teeth a more naturalappearance. Orthodontic appliances move existing teeth to enhancefunction and/or appearance.

In general, the procedures described above involve transfer of a dentalimpression to a laboratory for fabrication of the final dental object.In some cases, such as implants, a number of impressions may be takenover the course of treatment. Using a scanner such as that describedabove, a dentist may capture an accurate three-dimensionalrepresentation of dentition and surrounding tissue and transmit thisdigital version of the dental impression to a dental laboratory using anetwork such as the internetwork 210 described above. The dentallaboratory may receive the data and proceed with any appropriatefabrication. In various procedures, the three-dimensional representationmay include data from two or more scans, such as an initialthree-dimensional representation of dentition prior to any dental work,and a prepared three-dimensional representation of the dentition afterone or more tooth surfaces have been prepared for the dental object(s).The surface preparation may provide guidance to the laboratoryconcerning fit of the restoration or other dental object to the toothsurface, and the initial scan may provide valuable informationconcerning the appropriate dimensions for the final dental object andits relationship to surrounding teeth. A dentist may also optionallyspecify a number of parameters for the dental laboratory as described invarious examples below.

Where a particular dental object is temporary, or will be covered byanother dental object at a subsequent dental visit, the object may befabricated with one or more characteristics that improve scanning of anyexposed surfaces once the object is placed within a dental patient'smouth. For example, an object such as an impression coping, fixture, orhealing abutment may be fabricated with scanning-optimized surfaces suchas an optical or textured finish. An optical finish may, for example,include randomly (or pseudo-randomly) distributed coloration such asblack or other high-contrast dots. A textured finish may, for example,include a pseudo-random texture or one or more discrete landmarks.

It will be appreciated that in certain embodiments the dental laboratorymay be an in-office dental laboratory physically located within or neara dental office where a dental patient is receiving treatment. Invarious embodiments, the in-office dental laboratory may providefacilities for a subset of dental objects described above, such as thosemost commonly used by a particular dentist.

Rapid manufacturing facilities may also be employed with the systemsdescribed herein. A rapid manufacturing facility may include equipmentfor designing and/or fabricating dental objects for use in dentalprocedures. A client 202 at a rapid manufacturing facility may becoupled in a communicating relationship with a client 202 at one or moreof a dental office, another dental laboratory, a rapid manufacturingfacility, and/or a dental data center for communication ofthree-dimensional representations of dental subject matter and relatedinformation. This dental network may be usefully employed in diagnosis,case planning, consultation, evaluation, and the like.

Rapid manufacturing facilities may include, for example one or morestereo lithography apparatuses, three-dimensional printers, computerizedmilling machines, or other three-dimensional rapid prototypingfacilities or similar resources. A particular facility may include oneor more of a number of different types of machines which may bescheduled for various fabrication jobs received through the internetwork210. In one embodiment, a single facility may provide a large number ofmachines along with suitably trained technical personal to provide acentralized fabrication facility. In another embodiment, machines may bedistributed at various locations, including one or more machines withindental offices and dental laboratories. Where copings, crowns, or thelike are to be finished at the rapid manufacturing facility rather than,for example, a dental laboratory, the rapid manufacturing facility mayalso include machinery such as pressing machines and electroplatingmachines.

More generally, a dental fabrication facility may include one or more ofthe rapid manufacturing facilities, dental laboratory facilities, orin-office dental laboratories described above, either alone or incombination.

A dental data center may provide a hub for a digital dentistry network.A server 204 at a dental laboratory may be coupled in a communicatingrelationship with a client 202 at one or more of a dental office, adental laboratory, a rapid manufacturing facility, and/or another dentaldata center for communication of three-dimensional representations ofdental subject matter and related information. This dental network maybe usefully employed in diagnosis, case planning, consultation,evaluation, and the like. The dental data center may, for exampleoperate as an intermediary between dentists, laboratories, andfabrication facilities to provide a common repository for new dentaljobs from a dental office, which may be distributed to availableresources at one or more dental laboratories and/or rapid fabricationfacilities. In addition to scheduling and workload allocation, thedental data center may provide various value-added services such asquality control for incoming three-dimensional representation, financialtransaction management, insurance authorization and payment, and thelike.

The dental data center may coordinate a number of transactions within adigital dentistry network. For example, the dental data center mayengage in continuous bidding for fabrication work in order to ensurecompetitive pricing for fabrication facility and dental laboratory worksourced from the dental data center. As another example, the dental datacenter may provide status updates concerning a fabrication job to adentist or other participant, including up-to-date information such asjob received, job at fabrication facility, job at dental laboratory,model completed, waxing completed, investing completed, castingcompleted, porcelain build-up completed, restoration completed,finishing, shipping, and so forth. The dental data center may provide aweb-based work-in-progress interface through which a dentist may monitorprogress. Other known systems, such as electronic mail alerts or RSSupdates, may be used to provide status updates to dentists or otherinterested parties. While a dental data center may be usefully employedwith the digital dentistry systems described herein, it will also beunderstood that various dental networks may operate independentlybetween parties, such as between a dental office and a dental laboratoryor between a dental laboratory and a rapid manufacturing facility, orbetween a number of dental offices and a rapid manufacturing facility,without a centralized server at a dental data center. All suchembodiments are intended to fall within the scope of this disclosure.Further, it will be understood that a wide array of software platforms,communications protocols, security protocols, user interfaces, and thelike are known, and may be suitably adapted to a web-based, web-servicesbased, or other dental data center as described herein.

A digital dentistry network may include other participants, such as aconsulting dentist, and oral surgeon, an insurer, a federal or stateregulator or oversight entity, or any other dental entity. Each of theseparticipants may communicate with other participants in the digitaldentistry network through use of a client 202. Through this digitaldentistry network, various methods and systems may be deployed. Forexample, in one aspect a three-dimensional representation and a dentalprescription may be electronically transmitted to an insurer through thenetwork, and the insurer may respond with authorization to perform thespecified dental procedure (or a denial, which may include any reasonsfor the denial), including fabrication of any related dental objects.The insurer may maintain an electronic copy of three-dimensionalrepresentations relevant to the authorization, such as an image of thetooth surface prepared for the procedure. The insurer may also renderpayment, or authorize payment, to a treating dentist. The insurer mayalso, or instead, render payment to related entities, such as a dentallaboratory or rapid manufacturing facility, for fabrication servicesprovided. In one common practice, the insurer makes a single payment tothe treating dentist who may in turn contract desired vendors forfabrication services. However, the insurer may render paymentsseparately to one or more parties involved including a dentist, a dentalpatient, a dental laboratory, a rapid manufacturing facility, and so on.

In one aspect, dental laboratory procedures may be improved byfabricating a kit of components for use by a dental laboratory insubsequent fabrication of a final restoration, prosthesis, or the like.For example, a kit may include one or more of a die, a quad model, anopposing quad model, a full arch model, an opposing arch model, a base,a pre-articulated base, a waxup, and so forth. More generally, the kitmay include one or more pre-cut components, pre-indexed components, andpre-articulated components for assembly into a dental model, such as amodel adapted for use with an articulator. The kit may also, or instead,include various interim components of dental manufacture, such asrequired or commonly used components for particular procedures, e.g.,the PFM crown kit, the bridge kit, and so on. All or some of thesecomponents may be automatically fabricated as a kit by a productionfacility specializing in high-throughput such as the rapid manufacturingfacility described above, and the kit may be forwarded to a dentallaboratory specializing in creation of final restorations and the like.This approach leverages the relative expertise of these two participantsin a digital dentistry network, and may achieve significant decreases incost and time to a final restoration or other dental object.Alternatively, a dentist may determine and directly fabricated anyrequired kit components using, for example, an in-housethree-dimensional printer. In one aspect, a group of different kits maybe established for different dental work, so that a dental prescriptionautomatically triggers fabrication of the corresponding kit.

FIG. 3 shows a user interface that may be used in a digital dentalsystem. The user interface may be presented, for example, as a Web pageviewed using a Web browser, or as an application executing on one of theclients 202 described above, or as a remotely hosted application, or asa combination of these.

The interface 300 may include navigation features such as a home control302, a name directory control 304, a toolbox control 306, and a securitycontrol 308. Each of these features may direct the interface 300 to adifferent functional area. For example, the home control 302 may accessa top level menu that provides access to, for example, system login,data source selection, hardware/software configuration, administrativetools, and so forth. The name directory control 304 may access adirectory of patients, physicians, dental laboratories, rapidmanufacturing facilities and like, and permit searching, data input, andso forth. The directory may, for example, provide access to patientdental records and history, contact information, and the like. Thetoolbox control 306 may provide access to tools for scanning, caseplanning and management, scheduling, and the like. The security control308 may provide access to account management, communicationsconfiguration, and other security-oriented features and functions of adigital dentistry system.

Within each main area of top-level navigation, the interface 300 mayprovide a number of tabs, such as the scanning tab 310, the prescriptiontab 312, and the status tab 314 depicted in FIG. 3. The scanning tab 310may, for example, invoke an interface for controlling operation of animage capture system 100 such as that described above in reference toFIG. 1. The prescription tab 312 may, for example, invoke an interfacethat permits specification of a restoration or other dental object,including a specification of teeth being treated, treatment type,manufacturer, and details of the dental object including color,material, texture, and so forth. The interface of the prescription tab312 may also include tools for transmitting a prescription, along withany three-dimensional data obtained from scans of a patient, to a dentallaboratory, dental data center, rapid manufacturing facility, or thelike The status tab 314 may, for example, invoke an interface forobtaining or updating status information on a case such as thefabrication status of a prescription (e.g., prescription and scanreceived, scan evaluated and approved, models complete, objectfabricated, object shipped to dentist, and so forth).

FIG. 3 depicts in more detail a prescription window of the interface300, as accessed by selecting the prescription tab 312. This window mayshow current data for a prescription within a text window 320. A scrollbar 322 or other control may be provided for selecting options relatingto a prescription. In operation, and by way of example only, a featureof the prescription, such as the material or manufacturer, may behighlighted within the text window 320, and options for that feature mayselected from the scroll bar 322. The window may also include additionalnavigational or process controls such as a next button 324, a backbutton 326, and a finish button 328, which may be used to navigatethrough one or more different windows of a prescription and/or caseplanning interface. This may include, for example, input of patientdata, selection of a dental laboratory, scheduling of dental visits, andthe like. It will be understood that the above interface 300 is anexample only and that other hierarchical arrangements of functions,and/or arrangements of data and controls within a particular interface,are possible and may be employed with a digital dental system asdescribed herein. For example, the interface may control scanning,marking or annotation of scanned models, case planning, access todatabases of patient records and dental data, preparation ofprescriptions, analysis of dentition, scheduling, management of patientdata, communications with remote fabrication facilities, and so forth.Any user interface or combination of user interfaces and user interfacetechnologies suitable for a digital dental system as described hereinmay be employed without departing from the scope of this disclosure. Assuch, a user interface 300 should be understood more generally withreference to the systems and methods described herein, and not byspecific reference to the example interface shown in FIG. 3.

Having described a number of aspects of a digital dentistry system andnetwork, along with various participants in such a network, specificuses of the system will now be discussed in greater detail.

FIG. 4 depicts a quality control procedure for use in a digital dentalsystem. The process 400 may start 402 by obtaining a digital model, suchas a three-dimensional representation of dental subject matter asdescribed generally above.

The digital model may include a single model, such as a digital model ofdentition prior to any dental work, such as for archival or comparisonpurposes. This may also, or instead, be a digital model of dentitionincluding one or more prepared surfaces, such as a single tooth surfaceprepared for a crown, or a number of tooth surfaces prepared for amulti-unit bridge. This may also include a scan of bite registration.For example, a scan may be obtained of the teeth of a dental patient incentric relation, centric occlusion, or with maximum intercuspation, inprotrusion (e.g., for sleep apnea guards), in lateral excursions, or inany other static orientation useful for any of the dental proceduresdescribed herein. As a significant advantage, the upper and lower archesmay be treated as rigid bodies, thus permitting relativethree-dimensional orientation for a full bite registration to beobtained from a scan of a relatively small region of the upper and lowerarches while in occlusion, such as centric occlusion. Thus for example,a three-dimensional scan that spans the two arches, such as a scan ofthe exterior surfaces of one or two teeth in a buccal or labial area,may be used to register bite. In addition, the digital model may includemotion information describing the relative motion of, e.g., an upper andlower jaw throughout one or more jaw motions such as opening and closingthe mouth or simulated chewing. Such motion data may, for example, beobtained through a variety of techniques suitable for trackingthree-dimensional motion, which may include extrapolation from videodata, use of transmitters on the moving jaws, mechanical orelectromechanical sensors and/or transmitters, and so forth. Motion datamay also be inferred by capturing orientation data for the jaws in avariety of positions. Motion data may be employed, for example, toderive the position of TMJ condyle paths of rotation and translation, orto provide input to a virtual or conventional dental articulator.

In addition, dynamic three-dimensional data may be obtained and used. Asnoted elsewhere herein, some systems permit direct three-dimensionalvideo capture. However, other techniques may be employed to capturedynamic data. For example, in one example process, two opposing archesmay be brought into natural occlusion. The dental patient may then slidethe arches forward and back and from side to side, during which thescanner may capture relative motion of the two rigid bodies defined bythe two opposing arches. The captured data may be used to characterizeand animate a three-dimensional transformation that captures the fullexcursion of the dentition. This data may, in turn, be registered todetailed scans of the opposing arches. As a further use of this type ofdata, the excursion data may be used in combination with detailed archdata to provide a cutting tool or path for occlusal surfaces of arestoration. Thus, occlusal surfaces may be measured or otherwisedetermined during a scan, and applied to define surfaces of arestoration. Using various CAD modeling tools, the restoration may befurther refined, such as by shaping side walls of the restoration,adding visually appealing and/or functional cusps to the occlusalsurfaces, and so forth. Thus in one aspect there is disclosed herein amethod for determining one or more occlusal surfaces of a dentalrestoration using dynamic three-dimensional data acquired during a scan.The method may include obtaining a three dimensional model of twoopposing arches of a patient's dentition, obtaining excursion data forthe two opposing arches, preparing a tooth surface of the dentition fora restoration, and determining an occlusal surface of the restorationusing the excursion data and the three-dimensional model.

More generally, any digital model or other data useful in dentalprocedures, restorations, and the like as described herein may beobtained in step 404.

Once a digital model (or models) is obtained in step 404, the process400 may proceed to one or more quality control steps as depicted insteps 406-410.

This may include automated quality control, as shown in step 406, whichmay be simple quantitative analysis such as measures of accuracy,variability, or density of three-dimensional surface data for a digitalmodel. This may also, or instead, include more sophisticated, automatedanalyses such as adequacy and/or suitability of margins and preparedsurfaces for an anticipated restoration. For example, an automatedquality control tool may examine a prepared tooth surface to ensure thata margin line is present all the way around a preparation, or examinethe prepared surface to ensure that adequate material has been removedto accommodate a restoration. Similarly, an automated process may locateareas of potential problems, such as occlusal high spots, occlusalclearance, occlusal irregularities, areas of poor margin preparation,areas of inadequate tooth removal, improper taper, improper draw path orremoval path for a multiple unit preparation, inappropriate contour, andso forth.

In one aspect, quality control may include real time feedback during ascan, or between successive scans. The feedback may be rendered withsuitable visualizations on a display to permit immediate observation andcorrection by a dentist. Thus it will be appreciate that, while depictedin FIG. 4 as a post-scanning operation, quality control may beimplemented at any time in a digital dentistry process, or throughoutthe entire process. Real time feedback may include for example, textualannotations identifying teeth as they are recognized within a scan, andproviding one or more dimensions of a tooth, or an analysis of contour,clearance relative to adjacent teeth, or a position of the toothrelative to other teeth or relative to a global coordinate system. Byproviding this information in real time within the context of a singledental visit, treatment may be generally improved by reducing oreliminating a need for follow up scans.

In another aspect, quality control may include an evaluation ofsuitability of a surface preparation, or a restoration or other dentalobject prepare for the restoration, for manufacturing using one or moretechniques, including three-dimensional printing, milling, stereolithography, and or conventional dental fabrication, or variouscombinations of these.

Although not depicted in FIG. 4, it will be appreciated that qualitycontrol may be semi-automated. Thus, for example, a user interface mayprovide a number interactive, three-dimensional tools such as markuptools that a dentist or other dental professional may use to measure,mark, annotate, or otherwise manipulate a digital model to evaluatesuitability for subsequent processing and the creation of a physicaldental object such as a restoration.

As shown in step 408, quality control may include manual qualitycontrol. For example, a dentist may inspect a scan in an interactive,three-dimensional environment to visually identify, e.g., holes or areasof incomplete scan needed for an intended dental procedure. The dentistmay employ various features, such as rotation, zooming, and panning toinspect various surfaces of the three-dimensional digital representationfrom a scan.

As shown in step 410, quality control may include remote qualitycontrol. For example, after completing a scan, a dental office maytransmit a digital model to a dental laboratory or a fabricationfacility for evaluation of adequacy of the scan. As a significantadvantage, the recipient, such as a dental laboratory may provideimmediate feedback to a dentist while a dental patient is still in thedental office, or still in a dentist's chair at a dental office, thusavoiding a need to schedule repeat visits for additional surfacescanning or surface preparation. A dental laboratory may inspect aprepared surface to ensure that a restoration can be fit to the preparedsurface, or that there is adequate space (especially thickness) for arestoration or other dental object. The dental laboratory may alsoevaluate color and suggest shade matching for a dentist. The dentallaboratory may request manual marking of a margin by a dentist where themargin is not visible on a prepared tooth surface. The dental laboratorymay also apply separate standards for data quality (density, accuracy,surface continuity, feature detail, etc.), and may request additional ornew scan data consistent with its own specifications. The dental officemay transmit a case plan prior to (or during) transmission of a scan,which may permit more detailed analysis of the scan data by therecipient. Thus, for example, a dental laboratory may evaluatesuitability of the scan and/or surface preparation for a type ofrestoration and any prescribed components (e.g., full ceramic,porcelain-fused-to-metal, etc.). Where the dental laboratory can quicklygenerate an accurate or rough model for a restoration or other dentalobject according to any fabrication or end use constraints, the roughmodel may, in digital form, be virtually fit to the prepared surface,and feedback may be provided to a dentist such as an identification ofregions requiring further reduction.

Quality control, whether automated or manual, and whether local orremote, may include a variety of different dental evaluations. Forexample, a prepared tooth in an arch that will receive a restoration maybe evaluated to determine whether there is adequate space for cement tobond the restoration to the prepared tooth surface. As another example,a dentist may visually confirm accuracy of a scan by inspection forgross errors or omissions such as holes, gaps, distortions, twists, andthe like. The dentist may also visually inspect margin lines on surfacepreparations, and may annotate margins for identification by a dentallaboratory or other fabrication facility. Similarly, a dental laboratorymay, during a quality control evaluation, request that the dentistidentify the margins on a surface preparation where the margin lines arenot self-evident.

Feedback from a quality control step, whether automated or manual, andwhether remote or local, may include various forms of feedback. Forexample, an evaluation may conclude with an identification of regions ofa prepared tooth surface requiring additional preparation or reduction,or regions of a digital model requiring additional or supplementalscanning due to incomplete, erroneous, or potentially erroneous data,which may be identified, for example, by comparison to models ofexpected shape for dentition, surface preparations, and the like. Anevaluation from a dental laboratory may request new data, or additionalshaping of a prepared surface. An evaluation from a dental laboratorymay include a request for an oral consultation. In addition other dentalprofessionals such as a consulting dentist, an oral surgeon, a dentalspecialist, or a laboratory technician may be called upon forevaluation, approval, and/or recommendations. Feedback may be presentedto a dentist in a number of forms. For example, the feedback may includetext or audible narrative concerning additional scanning, additionalsurface preparation, or requests for confirmation. The feedback may begraphical feedback provided by highlighting questionable or erroneousareas of a preparation within a rendered display of scan data. Thefeedback may identify corrective action on a scan or a surfacepreparation. The feedback may identify a margin line which may bedisplayed on a two-dimensional rendering of a three-dimensionalrepresentation, and a user interface may permit the margin line to beedited or confirmed. The feedback may include a visual display withregions of inadequate margin highlighted, such as through use of color,texture, or explicit annotations, arrows, callouts, or the like, and anycombination of these.

It will be understood that the quality control steps indicated in FIG. 4are not mutually exclusive. That is each of the quality control steps406-410 may be performed during the process 400, such as in sequence orin parallel (as where a dentist and a laboratory evaluate a scansimultaneously), and all such variations are intended to fall within thescope of this disclosure.

Any of the quality control steps above may advantageously be performedwhile a dental patient is still present at a dental office, or while thepatient is still in a dental chair, thus reducing or eliminating theneed for follow up dental visits for additional scanning.

After one or more quality control steps 406-410, a determination may bemade as to whether a scan and/or surface preparations are satisfactory.If the data is not satisfactory, the process 400 may proceed to step 414where the digital model may be supplemented or replaced with new scandata. This may include, for example, new scanning to replace apparentlyerroneous or inadequate scan data, or a new scan of the dental subjectmatter following, e.g., additional surface preparation consistent witherrors identified during quality control. The process 400 may thenreturn to step 404 where a new digital model is obtained.

If it is determined in step 412 that the data is satisfactory, theprocess 400 may proceed to step 416 where a dentist may prepare aprescription. The prescription may include, for example, a dentalpatient identification, an identification of one or more teeth beingtreated, a type of treatment (e.g., for a restoration, one or more of abridge, a crown, an inlay, a laminate veneer, an onlay, or a temporary),an identification of missing teeth (if appropriate), a material orfabrication technology (e.g., full ceramic, cast metal, PFM, etc.), analloy type (e.g., for a PFM crown), a manufacturer (e.g., Cercon, Cerec,Empress, Everest, Lava, Procera, etc.), limited occlusal clearance(e.g., enamalplasty, reduction coping, etc.), a shade guide (e.g., Vita3D Master, Vita Classical, etc.), a surface texture, a surface glaze, anopacity, an occlusal staining, dental notes, and any other informationrelevant to identification or preparation of the dental object. Forexample, for a crown the specification may include a material type, adesign (such as metal band, 360-degree facial butt porcelain shoulder,facial butt porcelain shoulder, metal occlusal surface, or no metalshowing), a return (e.g., biscuit bake, finish, metal try-in, etc.).Each specification may include subspecifications. For example, a metalband crown may be specified as having the metal band located at a buccallocation, a lingual location, or 360-degree.

As shown in step 418, once the prescription has been completed, thedigital model and prescription may be uploaded to a dental laboratory orother fabrication facility using, for example, the dental networkdescribed above. The process 400 may then end, as shown in step 420.

It will be understood that numerous variations and modifications to theabove process 400 may be used. For example, the prescription may beprepared at a different point in the process, such as before scanning sothat the prescription data may be used to evaluate sufficiency of thescan data. As another example, each digital model (e.g., native toothsurfaces, bit registration, prepared tooth surfaces) may be separatelypresented to one or more quality control steps, or the entire digitalmodel may be obtained prior to any quality control analysis. All suchvariations and modifications are intended to fall within the scope ofthe methods and systems described herein.

FIG. 5 shows a dental laboratory procedure using a digital dental model.While described as a dental laboratory procedure, it will be understoodthat the fabrication and quality control procedures described withreference to FIG. 5 may be performed by any fabrication facilityincluding a dental fabrication facility such as a dental laboratoryequipped to receive digital dental data, a model production laboratory(such as a rapid fabrication facility, milling facility, and the like),an in-office dental laboratory at a dental office, or any other dentalfabrication facility. The fabrication facility may include a remotefacility accessible through the dental network, and digital dental datamay be communicated to the fabrication facility directly or through ahub for dental data such as the dental data center described above.

As shown in step 504, the process 500 may start 502 by receiving adigital model from a dentist or other source. This may include, forexample, a digital model, such as a digital surface representationobtained using the image capture system 100 described above, of asurface prepared for a restoration such as a crown, or any other dentalobject.

As shown in step 506, the dental laboratory may design and/or fabricatea restoration or other dental object based upon the digital modelreceived in step 504. This may include a variety of fabricationtechniques, including working from a physical cast of a dentalimpression created using conventional dentistry techniques, orthree-dimensional printing or other fabrication techniques tomanufacture various interim components of dental manufacture such asdies, casts, and the like, or direct fabrication of a virtually designedrestoration, such as through computerized milling of the restorationfrom ceramic.

In one aspect, designing the restoration may include a step of virtuallyadding a die spacer to a digital model. It is known in dentistry toemploy a die spacer—a thin layer painted onto regions of dental modelsto—improve the final fit between a prepared tooth surface in a dentalpatient's mouth and a restoration or other dental object. The die spacermay for example provide a small void between a cast of the preparedsurface and a restoration constructed for the cast which may provide avoid for cement used with the final fitting, or to account for sizechanges in the restoration fabrication process. The die spacer may bevirtually added to a digital model of a prepared surface to achieve asimilar effect with a restoration that is to be directly fabricated fromthe digital model, or an interim component such as a fabricated cast ofa dental impression used to create the restoration. Similarly, where acast dental model is to be fabricated from a digital model, the diespacer may be added to appropriate regions of the prepared surface andany other suitable surfaces to remove or reduce the need for use of diespacers in subsequent fabrication steps. More generally, a virtual diespacer may be added to a digital model of a conventional dental model, adie, a waxup, or any other interim component of dental manufacture toaccount for a cementation void or other physical variations in thedesign of a final restoration. This cementation void or virtual diespacer may be fabricated directly into a die, waxup, or other interimcomponent that may be three-dimensionally printed or otherwisemanufactured from the digital model.

Thus in one aspect, disclosed herein is a virtual die spacer. Infabricating a dental restoration, a virtual dies spacer or cementationvoid may be specified, either by an originating dental office or adental laboratory, and this void may be automatically or manually addedto appropriate regions of a digital model to provide a correspondingcementation void in a final restoration. As a significant advantage, thethickness of the virtual die spacer may be explicitly specified, and maybe adjusted according to, for example, a dentist's preference oraccording to a type of cement to be used with the restoration. Dentistpreferences concerning die spacer thickness may also be stored forreuse, and dentist feedback (e.g., “too tight” or “inadequate void”) maybe recorded to provide sizing for a final restoration or other dentalobject that more closely meets and individual dentist's expectations.

In another aspect, designing the restoration may include virtuallyditching a die for a restoration. In conventional dentistry, a materialmay be cut away from a die below the margin line (which would otherwiseinclude bone, soft tissue, and the like) prior to use as a restorationmodel. This operation may be performed virtually within a user interfacethat includes interactive tools for manipulating a three-dimensionalrepresentation of dentition. Initially, this may include an automated,semi-automated, or manual step of defining a die in three-dimensionalspace by identifying a plane, a point, or a line used to separate a diefrom a model in an operation analogous to physically cutting a die froma conventional dental model. This may be followed by additional stepssuch as separate steps of explicitly identifying a margin line with afirst tool and then manipulating the digital model “below” the marginline, i.e., away from the tooth surface fitted to a restoration, with asecond tool to remove unwanted or unneeded areas from a volume boundedby the digital surface representation. This process may besemi-automated or automated, such as by automatic identification of themargin line and removal of a predetermined amount of sub-margin volume.The ditched die may then be directly fabricated using techniquesdescribed above.

Regardless of the interim modeling and fabrication steps, this step mayresult in a restoration in physical form, such as a crown, bridge,inlay, onlay, or other dental object intended for use by a dentalpatient.

As shown in step 508, the restoration may be scanned using, for example,an image capture system 100 such as the system described above withreference to FIG. 1, to obtain a scanned restoration.

As shown in step 510, the scanned restoration may be test fit to thedigital model received in step 504, such as by virtually superimposingthe scanned restoration to the digital model. This may permit evaluationof a variety of fit criteria prior to an attempt to fit the physicalrestoration to a prepared surface in the dental patient's mouth. Thisincludes, for example, an evaluation of margin fit, an evaluation ofvoid space for cement used to affix the restoration to the preparedsurface, and any other evaluation relating the prepared surface directlyto the restoration or abutting tooth surfaces. This may also include anevaluation of bite, occlusions, lateral excursions and any otherevaluation relating to jaw motion or the mating of lower and upperarches with the restoration in place.

In another aspect, test fitting may include measuring dimensionalaccuracy of the scanned restoration. For example, the restoration inthis context may include a prosthesis, an implant, an appliance, arestorative component, an abutment, a fixture, or any other dentalobject. The scanned restoration may be measured for fit between adjacentteeth, or for evaluation of contact points with teeth of an opposingarch when the restoration is fitted to a prepared surface (or morespecifically, when the scanned restoration is virtually fitted to a scanof the prepared surface), or a fit to the prepared surface, possiblyincluding an allowance for die spacing on one or more surfaces. Adentist may specify a desired tightness of fit, which may be quantifiedobjectively (e.g., in millimeters or microns) or subjectively (e.g.,loose, average, tight, etc.).

In one aspect, feedback from specific dentists may be monitored, so thatsubsequent restorations may more closely meet each dentist'sexpectations for a desired tightness of fit.

In another aspect, measuring dimensional accuracy may include evaluatinga quality of margin fit between a scanned restoration and a scannedsurface preparation, in order to avoid fitting difficulties at the timeof fitting the physical restoration to a patient's dentition.

As shown in step 512, the test fit of step 510 may be followed by adetermination of whether the physical restoration is satisfactory. Ifthe physical restoration is not satisfactory, the process 500 mayproceed to step 514 where the physical restoration is reworked, or a newrestoration prepared. If the physical restoration is satisfactory, thephysical model may be sent to a dental office for a final fittingprocedure in the dental patient's mouth. It may also be advantageous toalso forward the scan of the restoration to the originating dentaloffice in order to begin preparation for the final fitting procedure.The process 500 may then end 518.

It will be understood that numerous variations and modifications to theabove process 500 may be used. For example, although not depicted inFIG. 5, in certain instances where it appears that a physicalrestoration cannot be properly fabricated to fit the restoration site,e.g., the prepare surface and surrounding dentition, the dentallaboratory may contact the originating dental office to requestadditional preparation of the target surface. All such variations andmodifications are intended to fall within the scope of the methods andsystems described herein.

It will further be appreciated that, even in a system where the digitalsurface representation is used directly to fabricate a cast dental modelto which subsequent, conventional dental laboratory techniques areapplied, significant advantages may be realized through elimination ormitigation of physical handling and shipping of a dental impression.Thus in one aspect, there is disclosed herein a technique for acquiringa digital model, such as a digital surface representation, of a preparedsurface and/or surrounding dentition, and transmitting the digital modelto a dental laboratory or rapid manufacturing facility for preparationof a restoration or other dental object.

FIG. 6 illustrates a scan path that may be used with a three-dimensionalimage capture system. In a system that operates to continuously acquirethree-dimensional data in real time, and fits or registers incrementalthree-dimensional data to an aggregate three-dimensional model, it maybe advantageous to scan in a manner that increases registration to theaggregate model. Thus, for example, a scan path that runs adjacent toedges of the aggregate model may provide additional registration or fitinformation and improve overall accuracy, particularly over largesurfaces. With respect to scans of human dentition, this generalapproach suggests an s-shaped scan that traces from interior to exterior(or exterior to interior) surfaces of one tooth, and then reversesdirection to trace an exterior-to-interior path immediately adjacent tothe initial path, which may reduce overall spatial error betweenextremities of the arch. Without loss of generality, a more detailedexample of this approach is set out below.

A scan path 600 for obtaining three-dimensional data from a dental arch602 using a scanner such as the scanner 102 described above withreference to FIG. 1 may begin at a first lingual point 604. The scanpath may then traverse laterally over an occlusal point 606 or surfaceof a molar to a first buccal point 608, translate to a second buccalpoint 610 by moving forward along the gum line, and then traverselaterally over a second occlusal point to a second lingual point. Thescan path may then translate forward once again to a third lingualpoint, traverse laterally over a third occlusal point to a third buccalpoint, and once again translate forward. By scanning in this s-shapedmanner, each successive pass over occlusal surfaces may be fit to datafrom an adjacent pass over the occlusal surfaces, as well as to one ormore immediately prior frames of data. While the remainder of a scanpath is not illustrated in FIG. 6, it will be understood that the scanmay continue along the entire arch in this manner, finally reaching amolar 612 at the opposite extremity of the arch.

It will be understood that the spacing of adjacent passes may be greateror less than illustrated. For example, a buccal-to-lingual pass maycover a portion of a tooth, an entire tooth, or a number of teethdepending upon, for example, the field of view for data acquisition withthe scanner. It will also be understood that the starting and endingpoints of the generally s-shaped scan are somewhat arbitrary. A scan maybegin, for example at a lingual point, at an occlusal point, or at abuccal point. Further, the scan may begin at a molar, or the scan maybegin at an incisor, with two consecutive scans performed from thiscentral location to each molar extremity of the arch. All suchvariations are intended to fall within the scope of the scan pathdescribed herein. In general, regardless of the starting point, agenerally s-shaped scan may move along adjacent buccal-to-lingual passesin the manner described above. In one aspect, real-time feedback may beprovided to a user by displaying on a display a next appropriatedirection of motion for a scan that follows the generally s-shaped path.

FIGS. 7A and 7B show a modeling environment for creating alignmentguides for orthodontic hardware. A three-dimensional representation 702of dentition and surrounding soft tissue may be acquired from a dentalpatient as described generally above, and rendered within a userinterface 704 on a computer such as the image capture system 100described above, or more generally, the client 202 described above. Invarious embodiments, orthodontic hardware may be virtually placed on thethree-dimensional representation 702, which may be used to determineappropriate positions for one or more alignment guides, or brackets maythemselves be virtually positioned on the three-dimensionalrepresentation 702 with corresponding alignment guides being generatedby computer, or the alignment guides may be directly positioned on thethree-dimensional representation 702. The user interface may includeinteractive tools for virtually positioning orthodontic hardware and/orbrackets for orthodontic hardware and/or alignment guides onto thethree-dimensional representation 702 within the user interface 704. Thedesign of orthodontic hardware and any corresponding positioning ofbrackets or the like, may be performed by a dentist at a dental officeand transmitted to a dental laboratory or other fabrication facility, orthe unmodified three-dimensional representation may be transmitted tothe dental laboratory along with a prescription for orthodontichardware.

FIG. 7A shows a three-dimensional representation 702 with visualmarkings 706 that serve as alignment guides. This markedthree-dimensional representation 702, or digital dental model, may serveas a basis for subsequent fabrication of custom orthodontic hardware.The markings 706 may be fabricated directly into a physical realizationof the digital dental model, such as using pigmented printingtechniques, or the markings 706 may be added to the physical realizationafter fabrication using additional computerized or manual markingtechniques.

FIG. 7B shows a three-dimensional representation 702 with supports 708that serve as a physical alignment guide. This three-dimensionalrepresentation 702, or digital dental model, may serve as a basis forsubsequent fabrication of custom orthodontic hardware. As depicted, eachsupport 708 may include a horizontal top surface or shelf for supportingan orthodontic fixture or other hardware. However, it will be understoodthat any physical form capable of supporting or engaging the intendedhardware may suitable by employed, and fabricated into a physical model.The supports 708 may be fabricated directly into a physical realizationof the digital dental model using techniques such as three-dimensionalprinting, stereo lithography, or computerized milling.

The alignment guides may serve to guide positioning of an orthodonticfixture onto the physical realization of the digital dental model toassist in fabricating custom orthodontic hardware. In an additionalprocessing step, once the corresponding orthodontic hardware, such asbrackets, is positioned onto the physical model, the position of anumber of brackets may be captured in a physical template such as afoam, a vacuum-formed appliance, or the like, for direct transfer to anarch within a dental patient's mouth. The appliance may, for example, beformed of a soft, clear material for easy handling by a dentist and/orgreater comfort for a dental patient. In such a process, a treatingdentist may perform an additional scan of the patient's dentitionimmediately prior to affixing the brackets to ensure that the naturaldentition still corresponds closely to the model used for virtualbracket positioning.

In another embodiment, additional modeling may be employed to create avirtual bracket carrier model—a device to carry brackets in a specificrelative orientation—that can be physically realized as a bracketpositioning appliance through direct fabrication using any of thetechniques described above. The bracket carrier model may include one ormore alignment guides for brackets such as those described generallyabove. Brackets may then be attached to the bracket positioningappliance for transfer to an arch within a dental patient's mouth. Thetreating dentist may perform an additional scan of the patient'sdentition immediately prior to affixing the brackets to ensure that thenatural dentition still corresponds closely to the model used to createthe bracket positioning appliance.

It will be appreciated that the processes and methods disclosed hereinmay be realized in hardware, software, or any combination of thesesuitable for the three-dimensional imaging and modeling techniquesdescribed herein. This includes realization in one or moremicroprocessors, microcontrollers, embedded microcontrollers,programmable digital signal processors or other programmable device,along with internal and/or external memory. The may also, or instead,include one or more application specific integrated circuits,programmable gate arrays, programmable array logic components, or anyother device or devices that may be configured to process electronicsignals. It will further be appreciated that a realization may includecomputer executable code created using a structured programming languagesuch as C, an object oriented programming language such as C++, or anyother high-level or low-level programming language (including assemblylanguages, hardware description languages, and database programminglanguages and technologies) that may be stored, compiled or interpretedto run on one of the above devices, as well as heterogeneouscombinations of processors, processor architectures, or combinations ofdifferent hardware and software. At the same time, processing may bedistributed across devices such as a camera and/or computer in a numberof ways or all of the functionality may be integrated into a dedicated,standalone image capture device. All such permutations and combinationsare intended to fall within the scope of the present disclosure.

It will also be appreciated that means for performing the stepsassociated with the processes described above may include any suitablecomponents of the image capture system 100 described above withreference to FIG. 1, along with any software and/or hardware suitablefor controlling operation of same. The user interfaces described hereinmay, for example, be rendered within the display 110 of the imagecapture system 100 of FIG. 1.

While the invention has been disclosed in connection with certainpreferred embodiments, other embodiments will be recognized by those ofordinary skill in the art, and all such variations, modifications, andsubstitutions are intended to fall within the scope of this disclosure.Thus, the invention is to be understood with reference to the followingclaims, which are to be interpreted in the broadest sense allowable bylaw.

What is claimed is:
 1. A method comprising: seating a dental patient ina clinical office; acquiring a digital dental impression includingthree-dimensional digital surface data for one or more intraoralstructures from two dental arches of the dental patient, the digitaldental impression including bite registration data characterizing analignment of the two dental arches and dynamic informationcharacterizing relative motion of the two dental arches; transmittingthe digital dental impression to a dental laboratory before the patientleaves the office, the digital dental impression including a case planfor a dental restoration, wherein the case plan specifies a cementationvoid for the dental restoration; and receiving an evaluation of the caseplan from the dental laboratory before the patient leaves the officebased upon the bite registration data, the dynamic information, and thedynamic information, the evaluation including an identification of atleast one region of the one or more intraoral structures requiringadditional preparation of the one or more intraoral structures requestedby the dental laboratory to prepare the dental restoration based uponthe case plan.
 2. The method of claim 1 further comprising preparing theone or more intraoral structures according to the evaluation.
 3. Themethod of claim 1, wherein the evaluation includes an evaluation ofsurface continuity.
 4. The method of claim 1, wherein the evaluationincludes an evaluation of data density.
 5. The method of claim 1,wherein the evaluation includes an evaluation of feature detail.
 6. Themethod of claim 1, wherein one or more intraoral structures includes atooth surface prepared for a dental restoration.
 7. The method of claim1, wherein the case plan includes a type of restoration.
 8. The methodof claim 1, wherein the case plan includes a design of restoration. 9.The method of claim 1, wherein the case plan includes a list ofrestoration components.
 10. The method of claim 9, wherein the list ofrestoration components includes a full ceramic component.
 11. The methodof claim 9, wherein the list of restoration components includes aporcelain-fused-to-metal component.
 12. The method of claim 1, whereinthe case plan includes a specification of one or more restorationmaterials.
 13. The method of claim 1 wherein the additional informationrequested by the dental laboratory includes a request for manual markingof a margin on the digital dental impression.